Review
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World J Radiol. Apr 28, 2014; 6(4): 82-92
Published online Apr 28, 2014. doi: 10.4329/wjr.v6.i4.82
Role of interventional radiology in the management of acute gastrointestinal bleeding
Raja S Ramaswamy, Hyung Won Choi, Hans C Mouser, Kazim H Narsinh, Kevin C McCammack, Tharintorn Treesit, Thomas B Kinney
Raja S Ramaswamy, Hyung Won Choi, Kazim H Narsinh, Kevin C McCammack, Tharintorn Treesit, Thomas B Kinney, Department of Vascular and Interventional Radiology, University of California San Diego Medical Center, San Diego, CA 92103, United States
Hans C Mouser, Department of Radiology, Indiana University Medical Center, Indianapolis, IN 46202, United States
Author contributions: All authors contributed equally to this paper.
Correspondence to: Raja S Ramaswamy, MD, Department of Vascular and Interventional Radiology, University of California San Diego Medical Center, 200 West Arbor Drive, #8756, San Diego, CA 92103, United States. rramaswamy@ucsd.edu
Telephone: +1-619-5436222 Fax: +1-619-5431234
Received: December 15, 2013
Revised: February 20, 2014
Accepted: March 11, 2014
Published online: April 28, 2014
Processing time: 131 Days and 11.4 Hours
Abstract

Acute gastrointestinal bleeding (GIB) can lead to significant morbidity and mortality without appropriate treatment. There are numerous causes of acute GIB including but not limited to infection, vascular anomalies, inflammatory diseases, trauma, and malignancy. The diagnostic and therapeutic approach of GIB depends on its location, severity, and etiology. The role of interventional radiology becomes vital in patients whose GIB remains resistant to medical and endoscopic treatment. Radiology offers diagnostic imaging studies and endovascular therapeutic interventions that can be performed promptly and effectively with successful outcomes. Computed tomography angiography and nuclear scintigraphy can localize the source of bleeding and provide essential information for the interventional radiologist to guide therapeutic management with endovascular angiography and transcatheter embolization. This review article provides insight into the essential role of Interventional Radiology in the management of acute GIB.

Keywords: Interventional radiology; Angiography; Therapeutic management; Upper gastrointestinal bleeding; Lower gastrointestinal bleeding; Embolization

Core tip: Acute gastrointestinal bleeding can lead to significant morbidity and mortality without appropriate treatment. The role of interventional radiology is crucial in patients that have persistent bleeding despite medical and endoscopic treatment. Computed tomography angiography and nuclear scintigraphy can localize lesions and provide information helpful for the Interventional Radiologist. The source of bleeding can be then be stabilized with endovascular angiography/transcatheter arterial embolization which is safe and effective with minimal complications due to the advances in catheter technology.