Intervention Techniques and Embolic Agents in the Management of Intraabdominal Visceral Artery Hemorrhage

Management of Intraabdominal Visceral Artery Hemorrhage

Abstract

Background: There are significant morbidity and mortality in patients with acute gastrointestinal (GI) bleeding. As a multitude of pathologic processes results in GI bleeding, the diagnosis and management of GI bleeding are complicated, and it is intermittent in nature. Currently, in the evaluation and treatment of acute gastrointestinal (GI) hemorrhage, there are multiple imaging modalities and therapeutic interventions that are used. The aim is to study the Intervention techniques and embolic agents in the management of intra abdominal visceral artery hemorrhage at Narayana Medical College, Nellore. Subjects and Method: This was a prospective observational study done in the department of Radiodiagno- sis, Narayana medical college, Nellore.20 patients with intra abdominal visceral artery hemorrhage were referred from gastroenterology, gastro surgery, and nephrology to our department from December 2018 to December 2019, diagnosed by CT angio to have intra abdominal visceral artery hemorrhage due to various conditions like pancreatitis, trauma, post procedures like biopsy or drainage. These cases were managed on an emergency basis by embolization of the bleeding visceral artery. Results: Out of 20 patients, 95% were males, and 5% were females. The age range in this study is 16-75 years, with the underlying cause being pancreatic pseudoaneurysms in 12, post-biopsy in 4, post-surgical in 2, and trauma in 2 cases. Coil embolization was done in 13 cases, glue embolization in 6 cases, gel foam embolization in 1 case. Conclusion: Intervention radiology management with embolization has now become the first line of treatment in visceral artery hemorrhages. Knowledge about vascular anatomy, collaterals, techniques of embolization, indications of each embolic agent, and adequate expertise is very essential for the interventional radiologists ineffective management of these cases. When performed in time, these procedures are life-saving and precludes the need for surgery.