Massive Duodenal Bleeding after the Migration of Endovascular Coils into the Small Bowel
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Among gastrointestinal emergencies, acute upper gastrointestinal bleeding remains a challenging clinical problem owing to significantpatient morbidity and costs involved in management. Endoscopic hemostatic therapy is the mainstay of treatment and decreases theincidence of re-bleeding, the need for surgery, morbidity, and mortality. However, in 8%–15% of patients with upper gastrointestinalbleeding, endoscopic hemostatic therapy does not successfully control bleeding. Trans-arterial coil embolization is an effectivealternative treatment for endoscopic hemostatic failure; however, this procedure can induce adverse outcomes, such as non-targetvessel occlusion, vessel dissection and perforation, and coil migration. Coil migration is rare but causes severe complications, suchas re-bleeding and bowel ischemia. However, in most cases, coil migration is local and involves spontaneous healing without seriouscomplications. Here, we report the case of a patient who underwent trans-arterial coil embolization of the gastroduodenal artery withthe purpose of controlling massive duodenal bleeding, resulting in a fatal outcome caused by coil migration.
Abstract
Among gastrointestinal emergencies, acute upper gastrointestinal bleeding remains a challenging clinical problem owing to significantpatient morbidity and costs involved in management. Endoscopic hemostatic therapy is the mainstay of treatment and decreases theincidence of re-bleeding, the need for surgery, morbidity, and mortality. However, in 8%–15% of patients with upper gastrointestinalbleeding, endoscopic hemostatic therapy does not successfully control bleeding. Trans-arterial coil embolization is an effectivealternative treatment for endoscopic hemostatic failure; however, this procedure can induce adverse outcomes, such as non-targetvessel occlusion, vessel dissection and perforation, and coil migration. Coil migration is rare but causes severe complications, suchas re-bleeding and bowel ischemia. However, in most cases, coil migration is local and involves spontaneous healing without seriouscomplications. Here, we report the case of a patient who underwent trans-arterial coil embolization of the gastroduodenal artery withthe purpose of controlling massive duodenal bleeding, resulting in a fatal outcome caused by coil migration.
참고문헌 (12)
- Hearnshaw SA, "Acute upper gastrointestinal bleeding in the UK : patient characteristics, diagnoses and outcomes in the 2007 UK audit", Gut, 60, pp.1327~1335 (2011)
- Laine L, "Endoscopic therapy for bleeding ulcers : an evidence-based approach based on meta-analyses of randomized controlled trials", Clin Gastroenterol Hepatol, 7, pp.33~47 (2009)
- Laine L, "Management of patients with ulcer bleeding", Am J Gastroenterol, 107, pp.345~360 (2012)
- Shin JH, "Recent update of embolization of upper gastrointestinal tract bleeding", Korean J Radiol, 13(Suppl 1), pp.S31~S39 (2012)
- Loffroy R, "Embolization of acute nonvariceal upper gastrointestinal hemorrhage resistant to endoscopic treatment : results and predictors of recurrent bleeding", Cardiovasc Intervent Radiol, 33, pp.1088~1100 (2010)
- Singh G, "Endoscopic visualization of embolization coil in a duodenal ulcer", Gastrointest Endosc, 67, pp.351~352 (2008)
- Kuhara A, "Late-occurring coil migration into the duodenum", BMJ Case Rep, 2013 (2013)
- Jaurigue MM, "Recurrent upper GI bleeding secondary to coil migration in a patient with known NSAID-induced peptic ulcer disease", Gastrointest Endosc, 79, pp.1004~ (2014)
- García-Iglesias P, "Meta-analysis: predictors of rebleeding after endoscopic treatment for bleeding peptic ulcer", Aliment Pharmacol Ther, 34, pp.888~900 (2011)
- Lau JY, "Challenges in the management of acute peptic ulcer bleeding", Lancet, 381, pp.2033~2043 (2013)
- Yap FY, "Transcatheter embolotherapy for gastrointestinal bleeding : a single center review of safety, efficacy, and clinical outcomes", Dig Dis Sci, 58, pp.1976~1984 (2013)
- Loffroy R, "Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding : indications, techniques and outcomes", Diagn Interv Imaging, 96, pp.731~744 (2015)