| Theme |
Diagnoses & Treatments for Gastrointestinal Bleeding on the Basis of JGES Guidelines |
| Title |
Role of Interventional Radiology in the Management of Nonvariceal Gastrointestinal Hemorrhage |
| Author |
Jiro Sato |
Department of Radiology, The University of Tokyo Hospital |
| [ Summary ] |
Interventional radiology (IR) is a minimally invasive approach for treating gastrointestinal bleeding (GIB) resistant to conservative medical therapy. Most upper GIB cases undergo endoscopy and IR is usually performed after failed endoscopic hemostasis. On the other hand, IR is often recommended based on the findings of contrast‒enhanced computed tomography (CT) for lower GIB. Stabilization of the circulation and correction of any coagulopathy are desirable before IR. Selective embolization with a microcatheter is the first choice for treatment when active extravasation is noted on a digital subtraction angiography (DSA). However, it is not unusual for active extravasation to not be apparent on DSA. Patients with coagulopathy may be successfully treated with n‒butyl cyanoacrylate (NBCA) by a skilled interventional radiologist. The technical success rate of transcatheter embolization is high and the complication rate is low, but re‒bleeding often occurs and may be treated with repeated embolotherapies. |