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KEY FACTS
Terminology
Preprocedure
Procedure
Post Procedure
TERMINOLOGY
Definitions
- Upper gastrointestinal (UGI) hemorrhage
- Hemorrhage in territory supplied by celiac artery
- Boundary between UGI and lower GI hemorrhage
- Celiac artery-superior mesenteric artery (SMA) watershed zone
- Near ligament of Treitz
- Some hemorrhages can be supplied by both celiac artery and SMA
- Specifically, 2nd and 3rd portions of duodenum
- Upper and midesophagus are supplied by short aortic branches
- Lower esophagus is supplied by left gastric artery; branch of celiac artery
- Epidemiology
- ~ 375,000 patients receive treatment for arterial GI hemorrhage in USA annually
- > 80% have UGI source
- Prior to introduction of endoscopic/endovascular treatments, mortality was 25%; it is now ~ 5%
- ~ 375,000 patients receive treatment for arterial GI hemorrhage in USA annually
- Causes of UGI hemorrhage
- ~ 70% of UGI hemorrhage are due to gastric or duodenal ulcer disease of erosive gastritis/duodenitis
- Secondary causes of UGI hemorrhage
- Mallory-Weiss tear: ~ 6%
- Cancer: ~ 4%
- Other: ~ 20%
- Upper gastrointestinal (UGI) hemorrhage
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Equipment Preparation
Procedure Steps
Alternative Procedures/Therapies
POST PROCEDURE
Expected Outcome
Things to Do
Things to Avoid
OUTCOMES
Problems
Complications
Expected Outcome
Selected References
- Dariushnia SR et al: Society of Interventional Radiology quality improvement standards for percutaneous transcatheter embolization. J Vasc Interv Radiol. 32(3):476.e1-33, 2021
- Mujtaba S et al: Diagnosis and management of non-variceal gastrointestinal hemorrhage: a review of current guidelines and future perspectives. J Clin Med. 9(2), 2020
- Vora P et al: Thirty-year incidence and mortality trends in upper and lower gastrointestinal bleeding in Finland. JAMA Netw Open. 3(10):e2020172, 2020
- Warhadapande S et al: Clinical approach to and work-up of bleeding patients. Semin Intervent Radiol. 37(1):24-30, 2020
- Foltz G et al: Embolization of nonvariceal upper gastrointestinal hemorrhage complicated by bowel ischemia. Semin Intervent Radiol. 36(2):76-83, 2019
- Aquarius M et al: Prospective multicenter validation of the Glasgow Blatchford bleeding score in the management of patients with upper gastrointestinal hemorrhage presenting at an emergency department. Eur J Gastroenterol Hepatol. 27(9):1011-6, 2015
- Loffroy R et al: Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding: Indications, techniques and outcomes. Diagn Interv Imaging. 96(7-8):731-44, 2015
- Soto JA et al: Gastrointestinal hemorrhage: evaluation with MDCT. Abdom Imaging. 40(5):993-1009, 2015
- Dariushnia SR et al: Quality improvement guidelines for diagnostic arteriography. J Vasc Interv Radiol. 25(12):1873-81, 2014
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References
Tables
Tables
KEY FACTS
Terminology
Preprocedure
Procedure
Post Procedure
TERMINOLOGY
Definitions
- Upper gastrointestinal (UGI) hemorrhage
- Hemorrhage in territory supplied by celiac artery
- Boundary between UGI and lower GI hemorrhage
- Celiac artery-superior mesenteric artery (SMA) watershed zone
- Near ligament of Treitz
- Some hemorrhages can be supplied by both celiac artery and SMA
- Specifically, 2nd and 3rd portions of duodenum
- Upper and midesophagus are supplied by short aortic branches
- Lower esophagus is supplied by left gastric artery; branch of celiac artery
- Epidemiology
- ~ 375,000 patients receive treatment for arterial GI hemorrhage in USA annually
- > 80% have UGI source
- Prior to introduction of endoscopic/endovascular treatments, mortality was 25%; it is now ~ 5%
- ~ 375,000 patients receive treatment for arterial GI hemorrhage in USA annually
- Causes of UGI hemorrhage
- ~ 70% of UGI hemorrhage are due to gastric or duodenal ulcer disease of erosive gastritis/duodenitis
- Secondary causes of UGI hemorrhage
- Mallory-Weiss tear: ~ 6%
- Cancer: ~ 4%
- Other: ~ 20%
- Upper gastrointestinal (UGI) hemorrhage
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Equipment Preparation
Procedure Steps
Alternative Procedures/Therapies
POST PROCEDURE
Expected Outcome
Things to Do
Things to Avoid
OUTCOMES
Problems
Complications
Expected Outcome
Selected References
- Dariushnia SR et al: Society of Interventional Radiology quality improvement standards for percutaneous transcatheter embolization. J Vasc Interv Radiol. 32(3):476.e1-33, 2021
- Mujtaba S et al: Diagnosis and management of non-variceal gastrointestinal hemorrhage: a review of current guidelines and future perspectives. J Clin Med. 9(2), 2020
- Vora P et al: Thirty-year incidence and mortality trends in upper and lower gastrointestinal bleeding in Finland. JAMA Netw Open. 3(10):e2020172, 2020
- Warhadapande S et al: Clinical approach to and work-up of bleeding patients. Semin Intervent Radiol. 37(1):24-30, 2020
- Foltz G et al: Embolization of nonvariceal upper gastrointestinal hemorrhage complicated by bowel ischemia. Semin Intervent Radiol. 36(2):76-83, 2019
- Aquarius M et al: Prospective multicenter validation of the Glasgow Blatchford bleeding score in the management of patients with upper gastrointestinal hemorrhage presenting at an emergency department. Eur J Gastroenterol Hepatol. 27(9):1011-6, 2015
- Loffroy R et al: Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding: Indications, techniques and outcomes. Diagn Interv Imaging. 96(7-8):731-44, 2015
- Soto JA et al: Gastrointestinal hemorrhage: evaluation with MDCT. Abdom Imaging. 40(5):993-1009, 2015
- Dariushnia SR et al: Quality improvement guidelines for diagnostic arteriography. J Vasc Interv Radiol. 25(12):1873-81, 2014
