Published online Oct 28, 2013. doi: 10.3748/wjg.v19.i40.6869
Revised: July 29, 2013
Accepted: August 16, 2013
Published online: October 28, 2013
Processing time: 154 Days and 1.2 Hours
AIM: To evaluate the clinical results of angiography and embolization for massive gastrointestinal hemorrhage after abdominal surgery.
METHODS: This retrospective study included 26 patients with postoperative hemorrhage after abdominal surgery. All patients underwent emergency transarterial angiography, and 21 patients underwent emergency embolization. We retrospectively analyzed the angiographic features and the clinical outcomes of transcatheter arterial embolization.
RESULTS: Angiography showed that a discrete bleeding focus was detected in 21 (81%) of 26 patients. Positive angiographic findings included extravasations of contrast medium (n = 9), pseudoaneurysms (n = 9), and fusiform aneurysms (n = 3). Transarterial embolization was technically successful in 21 (95%) of 22 patients. Clinical success was achieved in 18 (82%) of 22 patients. No postembolization complications were observed. Three patients died of rebleeding.
CONCLUSION: The positive rate of angiographic findings in 26 patients with postoperative gastrointestinal hemorrhage was 81%. Transcatheter arterial embolization seems to be an effective and safe method in the management of postoperative gastrointestinal hemorrhage.
Core tip: Postoperative gastrointestinal hemorrhage is a potentially fatal complication after abdominal surgery. It is difficult for surgeons to deal with it. Reoperation is often difficult or even unsuccessful in patients with postoperative hemorrhage, especially those with two or more previous abdominal operations, due to the anatomical inaccessibility of the arteries, postoperative adhesions, and inflammatory reactions. This study showed that transcatheter embolization was a useful microinvasive treatment option for the identification and occlusion of a massive bleeding site after abdominal surgery.