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Related Concept Videos

Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
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Selective embolization for post-endoscopic sphincterotomy bleeding: technical aspects and clinical efficacy.

Young Ho So1, Young Ho Choi, Jin Wook Chung

  • 1Department of Radiology, Seoul National University Boramae Medical Center, Seoul 156-707, Korea.

Korean Journal of Radiology
|January 17, 2012
PubMed
Summary

Selective embolization effectively treats bleeding after endoscopic sphincterotomy. This interventional radiology technique, particularly targeting the posterior pancreaticoduodenal artery, offers a high success rate for managing this complication.

Keywords:
BleedingEmbolizationPancreaticoduodenal arterySphincterotomy

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Area of Science:

  • Interventional Radiology
  • Gastroenterology
  • Vascular Surgery

Background:

  • Post-endoscopic sphincterotomy bleeding is a significant complication.
  • Arteriography is used for diagnosing nonvariceal upper gastrointestinal bleeding.
  • Selective embolization is a potential treatment modality.

Purpose of the Study:

  • To evaluate the technical feasibility of selective embolization for post-endoscopic sphincterotomy bleeding.
  • To assess the clinical efficacy of selective embolization in achieving hemostasis.
  • To identify the common origins of bleeding vessels.

Main Methods:

  • Retrospective review of 10 patients undergoing selective embolization for post-endoscopic sphincterotomy bleeding.
  • Analysis of endoscopic procedures, bleeding onset, patient conditions, angiographic findings, and interventional outcomes.
  • Detailed examination of embolization techniques and materials used.

Main Results:

  • Achieved 83% primary hemostasis success, with 100% success after repeat embolization.
  • Bleeding occurred 1-8 days post-procedure in 80% of patients.
  • Posterior pancreaticoduodenal artery (67%) was the most frequent source of bleeding.

Conclusions:

  • Selective embolization is a technically feasible and effective treatment for post-endoscopic sphincterotomy bleeding.
  • The posterior pancreaticoduodenal artery is the primary culprit vessel in most cases.
  • Embolization offers a safe and successful management option with no reported rebleeding or complications.