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Revascularization of chronic occluded celiac artery for gastroduodenal coil embolization in massive upper
Esther H Shim1, Ryan Lydon2, Stephanie S Hyon1
1Department of Surgery, Morristown Medical Center, Morristown, NJ.
Insights
This case highlights a novel approach to managing severe upper gastrointestinal bleeding in a patient with celiac trunk occlusion. Successful recanalization and stenting enabled artery embolization, preventing complications.
Area of Science:
- Interventional Radiology
- Vascular Surgery
- Gastroenterology
Background:
- Upper gastrointestinal bleeding (UGIB) is a critical condition frequently associated with peptic ulcer disease.
- UGIB contributes significantly to patient morbidity and mortality, necessitating effective management strategies.
Observation:
- A 78-year-old male presented with severe UGIB refractory to endoscopic treatments.
- Angiography revealed celiac trunk occlusion, posing a risk of hepatic ischemia if the gastroduodenal artery was embolized directly.
Findings:
- A successful recanalization and stenting of the celiac trunk was performed.
- This intervention facilitated the subsequent safe and effective embolization of the gastroduodenal artery.
Implications:
- This case underscores the importance of evaluating visceral arterial anatomy and potential occlusions before interventions for UGIB.
- Considering anatomical variations and patient-specific risk factors is crucial for minimizing complications and improving outcomes in managing complex gastrointestinal bleeding.
- The presented technique offers a viable alternative for patients with challenging vascular anatomy presenting with upper gastrointestinal hemorrhage.
Abstract:
Upper gastrointestinal bleeding is a serious condition often linked to peptic ulcer disease, contributing to significant morbidity and mortality. A 78-year-old male presented with upper gastrointestinal bleeding that required blood product transfusions despite multiple endoscopic interventions. Although embolization or surgical ligation of the gastroduodenal artery was considered, angiography revealed celiac trunk occlusion, which would increase the risk of hepatic ischemia. Recanalization and stenting of the celiac trunk was performed, facilitating successful embolization of the gastroduodenal artery. This case illustrates the importance of considering anatomical variations and patient risk factors for visceral arterial occlusions, reducing morbidity and mortality.
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