[Embolisation procedures in acute haemorrhage from lower gastrointestinal tract]

Colonoscopy remains a method of choice in the management of acute bleeding from the lower gastrointestinal tract. However, the efficiency of the method to locate the source of bleeding and control is significantly lower, when the patient cannot be prepared for the procedure. When the source of bleeding is not possible to locate by endoscopy, the patient usually undergoes major surgery with high risk of complications or even death. The study analyzed the effectiveness of angiography with embolisation of arterial vessels supplying lower gastrointestinal tract as the alternative for surgical operation in cases when endoscopic procedures are ineffective in locating the source of bleeding. The analysis was conducted in 27 patients fulfilling the above criteria. All patients underwent diagnostic angiography which localized the source of bleeding in 19/27 (70%) of them. Embolisation procedures performed in 11/27 (41%) patient, while successful control of bleeding was achieved in 9/11 (89%) of them. No complications were found in the analyzed group related to the performed intravascular procedures. Positive effect of angiography, when embolisation is not possible to perform, may be the indication for targeted therapeutic endoscopy or selective surgical resection of the intestinal segment. The embolisation is safe and effective method of controlling acute lower gastrointestinal tract bleeding with low risk of ischemic complications.