Angiographic diagnosis and management of gastrointestinal hemorrhage. Current concepts

Gastrointestinal bleeding is now seen less often by the angiographer than in the past, owing to advances in pharmacology, endoscopy, and nuclear medicine. When patients with gastrointestinal bleeding are referred, it is often for therapy as well as diagnosis. Therapeutic options include infusion of vasoconstrictors and selective embolization, which is usually faster and more definitive. Depending on the agent used, embolization is generally quite safe and effective. The risk of ischemia is significant only in the colon or when collateral pathways have been previously interrupted. The management of variceal bleeding has changed significantly due to the advent of TIPS and the increasing availability of liver transplantation.