Radiologic Interventions for Gastrointestinal Bleeding.

Area of Science:

• Interventional Radiology
• Gastroenterology
• Vascular Imaging

Background:

• Gastrointestinal (GI) bleeding is a common emergency where endoscopy is the primary treatment.
• Some patients have persistent or recurrent bleeding, or lesions unsuitable for endoscopic therapy, necessitating alternative approaches.

Purpose of the Study:

• To review the role of radiological interventions in managing complex GI bleeding cases.
• To highlight imaging modalities and interventional techniques for both non-variceal and variceal GI bleeding.

Main Methods:

• Computed tomography angiography (CTA) for bleeding localization and vascular anatomy assessment.
• Transcatheter arterial embolization (TAE) for non-variceal bleeding.
• Transjugular intrahepatic portosystemic shunt (TIPS) and balloon-occluded retrograde transvenous obliteration (BRTO) for variceal bleeding.
• Percutaneous variceal embolization as an adjunctive therapy.

Main Results:

• CTA effectively localizes active bleeding and guides intervention.
• TAE demonstrates good outcomes for non-variceal GI bleeding.
• TIPS and BRTO are effective for managing variceal bleeding and portal hypertension.
• Percutaneous embolization offers an alternative when other methods fail.

Conclusions:

• Radiological interventions are vital for managing GI bleeding unresponsive to or unsuitable for endoscopy.
• Patient selection based on bleeding source, anatomy, and hemodynamics is crucial for successful outcomes.