Related Experiment Video
Updated: Aug 15, 2025
Integrated Compensatory Responses in a Human Model of Hemorrhage
Published on: November 20, 2016
Unmasking lower gastrointestinal bleeding under administration of norepinephrine
David John Werner1,2, Nicolai Wenzel1, Nael Abusalim1,3
1Department of Radiology, Helios Dr. Horst-Schmidt-Clinic, Wiesbaden 65199, Hessen, Germany.
Background:
Bleeding in the gastrointestinal tract is common and transarterial embolization enables the clinician to control gastrointestinal bleeding. Contrast extravasation is a prerequisite for successful embolization. Provocative angiography is helpful in the detection of elusive bleeding.
Aim:
We performed a retrospective analysis of angiographic treatment in patients with lower gastrointestinal hemorrhage and initially negative angiographies, as well as the role of norepinephrine (NE) in unmasking bleeding.
Methods:
We analyzed 41 patients with lower gastrointestinal bleeding after angiography who had undergone treatment over a period of 10 years. All patients had a positive shock index and needed intensive care.
Results:
In three of four patients, angiography disclosed the site of bleeding when NE was used during the procedure for hemodynamic stabilization.
Conclusion:
We suggest that angiography performed after the administration of NE in unstable patients with gastrointestinal bleeding and an initially negative angiography has the potential to unmask bleeding sites for successful embolization. However, this statement must be confirmed in prospective studies.
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