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Related Experiment Videos

Angiography in chronic/recurrent gastrointestinal bleeding: a nine year study.

E B Best, A K Teaford, F H Rader

    The Surgical Clinics of North America
    |October 1, 1979
    PubMed
    Summary

    Panvisceral arteriography identified the source of chronic gastrointestinal bleeding in 43% of patients. This diagnostic imaging technique revealed arteriovenous malformations in the gastrointestinal tract, including rare cases in the gastric antrum and left colon.

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    Area of Science:

    • Gastroenterology
    • Diagnostic Imaging
    • Vascular Surgery

    Background:

    • Chronic/recurrent gastrointestinal bleeding presents significant physical, psychological, and socioeconomic challenges.
    • Traditional diagnostic studies often fail to identify the bleeding source in these patients.

    Purpose of the Study:

    • To evaluate the diagnostic yield of aortography and panvisceral arteriography in patients with undiagnosed chronic/recurrent gastrointestinal bleeding.
    • To identify specific lesions, particularly arteriovenous malformations, responsible for obscure gastrointestinal bleeding.

    Main Methods:

    • Sixty patients with undiagnosed chronic/recurrent gastrointestinal bleeding underwent aortography and panvisceral arteriography (celiac, superior mesenteric, and inferior mesenteric).
    • Angiographic findings were analyzed to detect vascular lesions, with a focus on arteriovenous malformations.

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    Main Results:

    • Angiography yielded positive results in 26 patients (43% diagnostic yield).
    • Arteriovenous malformations were identified in 15 patients.
    • Unique findings included arteriovenous malformations of the gastric antrum (3 patients) and left colon (4 patients), with état mammelonné observed in two gastric cases.
    • Routine inferior mesenteric arteriography may explain the higher incidence of left colon arteriovenous malformations compared to other series.

    Conclusions:

    • Panvisceral arteriography is an effective diagnostic tool for identifying the source of chronic/recurrent gastrointestinal bleeding.
    • The study highlights the significance of arteriovenous malformations, including rare locations, in obscure gastrointestinal bleeding.
    • Continued use of panvisceral arteriography is warranted given its positive diagnostic yield in challenging cases.