Place of imaging in the management of acute upper gastrointestinal bleedings

Congress:

ECR 2019

Poster Number:

C-3595

Type:

Educational Exhibit

Keywords:

Obstruction / Occlusion, Haemorrhage, Acute, Venous access, Embolisation, Arterial access, Fluoroscopy, CT-Angiography, Catheter arteriography, Interventional vascular, Gastrointestinal tract, Abdomen

Authors:

D. Kontogom¹, D. CABRAL², N. ZHANG³, S. Binsse⁴, J. Sellier⁵, M. Sirol⁶, R. Y. Carlier¹, P. Lacombe⁴, M. El Hajjam⁴; ¹Garches/FR, ²Poissy/FR, ³Caen/FR, ⁴Boulogne-Billancourt/FR, ⁵Poitiers/FR, ⁶Paris/FR

DOI:

10.26044/ecr2019/C-3595

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-3595

Fig. 4: Vascularization of the stomach showing Dieulafoy's ulcer common place

Fig. 1

Fig. 2

Learning objectives

To recall the vascular anatomy of the gastro-intestinal tract. Togivethe timing and indications of abdominal CT-angiography in cases of upper gastro-intestinal (GI) bleedings. To show the role of interventional radiologyvs endoscopy in the management of uppergastro-intestinalbleedings.

Background

Management of gastrointestinal bleeding is primarily endoscopic according to the predominance of peptic ulcer disease with a great success rate (85 to 90%).In case of failure of a first endoscopy, a second must be attempted, with as much as possible the “marking” of the bleeding site by clips. After two unsuccessful endoscopic treatment attempts, are positioned interventional radiology with embolization and surgery, guided by abdominal angio-CT, with similar results.Embolization should be preferred to surgery especially in risky patients, because of co-morbidities and coagulopathy. OVERVIEW EPIDEMIOLOGY...

Findings and procedure details

Conclusion

Management of gastrointestinal bleeding is primarily endoscopic according to the predominance of peptic ulcer disease with a great success rate (85 to 90%).In case of failure of a first endoscopy, a second must be attempted, with as much as possible the “marking” of the bleeding site by clips. After two unsuccessful endoscopic treatment attempts, are positioned interventional radiology with embolization and surgery, guided by angioscan, with similar results.Embolization should be preferred to surgery especially in patients at risk because of co-morbidities and coagulopathy. Angioscan is...

Personal information

Contact details Denis KONTOGOM Former resident at the college of medicine of Paris in the Department of Medical Imaging and Interventional Radiology - HUPIFO-UVSQ – Boulogne-Garches. 104 boulevard Raymond Poincaré 92380 Garches – France. Email: [email protected] Author Information Denis Kontogom Former resident at the college of medicine of Paris in the Department of Medical Imaging and Interventional Radiology - HUPIFO-UVSQ – Boulogne-Garches. Mostafa El Hajjam (Department of Medical Imaging and Interventional Radiology - HUPIFO-UVSQ – Boulogne-Garches). Dominique Cabral (Department of Medical Imaging and Interventional Radiology...

References

Pateron D, Chaillet M, Debuc E. Digestive hemorrhages. Emergency Department, Saint-Antoine UniversityHospital Center, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France. E-mail: [email protected]. Maimouni S. Scientific exhibition : TDM in acute digestive hemorrhages. National Congress of Anesthesia and Resuscitation 2007. Les Essentiels, p. 477-486. © 2007 Elsevier Masson SAS. All rightsreserved. Richard L. Drake. Gray's Anatomy for Students, Elsevier Masson, 2nd edition, 2011. Sellier J. Digestive Hemorrhage and Interventional Radiology - 02/04/14. [33-665-A-35] - D01: 10.1016 / S1879-8527 (14) 67782-0. THE FUNDAMENTALS OF DIGESTIVE PATHOLOGY ©...