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Angiography in the Diagnosis and Treatment of Gastrointestinal Bleeding S. Kusano 1 , T. Kobayashi 1 , S. Matama 2 , T. Yarimizu 3 , H. Atari 4 1Department of Radiology, Kitasato University Hospital 2Department of Internal Medicine, Kitasato University Hospital 3Department of Surgery, Kitasato University Hospital 4Department of Pathology, Kitasato University Hospital pp.739-750
Published Date 1980/7/25
DOI https://doi.org/10.11477/mf.1403112668
  • Abstract
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 During the eight-year period from 1971 to 1979 at Kitasato University Hospital, angiography was performed in 94 out of 1,251 patients with gastrointestinal bleeding. 74 patients with angiographically veriied and/or treated gastrointestinal bleeding were analysed and discussed.

 Angiography has actually played an essential role in identifying sites of bleeding caused by vascular lesions, such as arteriovenous malformations, arteriovenous fistulas, aneurysms, and so on. Careful angiographic evaluation of arteriovenous malformations in the gastrointestinal tract may be of utmost importance for the diagnosis of the patients with gastrointestinal hemorrhage which is unexplainable despite repeated barium examination and endoscopy.

 Angiographic methods were also applied in the management of the patients with massive hemorrhage. 33 percent of the patients with active bleeding were uncontrolled with vasopressin infusion, although it was generally useful for control of bleeding from esophageal varices, stress ulcers, Mallory-Weiss syndrome, and so on. Transcatheter embolization with cyanoacrylate (Alonalpha A) was subsequently performed in these patients with active bleeding with vasopressin infusion or poor-risk patients not suitable for surgical therapy. Control of arterial bleeding from the gastrointestinal tract was achieved in 6 of 8 patients. Embolization of gastric veins resulted in temporary control of gastroesophageal variceal bleeding in 4 of 7 patients. At present, good judgement regarding surgical intervention following treatment by means of the angiographic methods is most important in the management of patients with massive hemorrhage.

 Some of the methods and complication of both vasopressin infusion and transcatheter embolization are disccussed and several examples are demonstrated.


Copyright © 1980, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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