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ENDOVASCULAR TREATMENT FOR UPPER GASTROINTESTINAL HAEMORRHAGE IN VIET DUC HOSPITAL
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Abstract
Objective: This study to evaluate the safety and effectiveness of endovascular intervention in treating upper gastrointestinal bleeding. Patients and methods: Retrospective study on patients with high gastrointestinal bleeding undergoing endovascular intervention at Viet Duc University Hospital between October 2017 and October 2022. Results: 65 patients, including 44 men and 21 women, with an average age of 56.5 years. Causes of bleeding: 24 patients after biliary-pancreatic surgery, 25 cases of peptic ulcer bleeding, 5 patients due to pancreatitis, 5 patients after biliary stenting or biliary surgery, 2 patients after pancreatic trauma injury, 3 patients due to vascular malformation, 1 patient due to bleeding duodenal tumour. 36 patients (55.4%) were performed gastroduodenal endoscopy before the intervention, of which 30 patients detected lesions, but failed to control bleeding under endoscopy. 43 patients received blood transfusion (66.1%), and 11 patients (16.9%) had received vasopressors before intervention. Vascular injuries were detected in 49 patients (75.4%): 20 had active bleeding, 28 had aneurysm pseudoaneurysm, and 1 had an artery dissection. 12 cases using coils (18.5%), 19 patients using glue (29.2%), 33 patients combining coils and bio-glue (50.7%), 1 case was temporarily blocked with gelfoam (1.6%). There was no recurrent bleeding after 24 hours and 5 recurrent bleeding after 14 days (7.7%). 2 patients presented with liver failure after separate hepatic artery occlusion, including 1 case of irreversible liver failure. 2 patients died within 30 days (3.1%). Conclusion: Endovascular intervention is a safe and effective method for treating upper gastrointestinal bleeding, especially in patients who have failed to medical therapy/endoscopic intervention or who have vascular complications after intervention or surgery.
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Keywords
upper gastrointestinal bleeding, gastrointestinal hemorrhage, embolization
References
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