Transcatheter Arterial Embolization in the Treatment of Abdominal Bleeding in Patients Being Treated with Open Abdomen Due to Duodenal Fistula

Abstract Purpose Transcatheter arterial embolization (TAE) is increasingly used for managing hemorrhage. The evidence-base supporting the procedure is accumulating. This study investigated the safety and effectiveness of TAE for intra-abdominal bleeding at a large regional public health service in Australia. Materials and Methods Medical records of all patients undergoing TAE for intra-abdominal bleeding over a 7-year period were retrospectively reviewed, excluding gastric bleeding. Data were extracted into a standardized electronic data collection tool. Technical success of TAE was defined as cessation of active contrast media extravasation on post-procedure angiography. Complications were categorized as intra- and post-procedure. The severity of complications was rated according to the Society of Interventional Radiology Standards of Practice Committee Classifications of Complications by Outcome. Results Ninety-two cases were identified. TAE was technically successful in 70 (94.6%) of the 74 cases when visible contrast media extravasation was evident during angiograph. During procedures, six minor complications occurred such as transient symptomatic hypotension or moderate to severe abdominal pain. Following procedures, eight minor complications were reported: seven cases of hematoma at the catheter access point and one case of contrast reaction. One major complication, bowel ischemia requiring hemicolectomy, occurred post-TAE for a bleeding cecal aneurysm; however, widespread arterial spasm was noted on angiography prior to TAE and interventional colonoscopy had occurred 2 days prior to TAE, suggesting that ischemia was not primarily due to TAE. Conclusion This study supports the use of TAE for a diverse range of cases of intra-abdominal bleeding. TAE produced high rates of complete hemostasis with few complications.

Download Full-text

A Case of Intra-abdominal Bleeding from a Posterior Superior Pancreaticoduodenal Artery Aneurysm following Total Gastrectomy Treated by Transcatheter Arterial Embolization

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) ◽

10.3919/jjsa.78.693 ◽

2017 ◽

Vol 78 (4) ◽

pp. 693-697

Author(s):

Masaki MORIMOTO ◽

Yasuro KURISU ◽

Satoshi NAGAI ◽

Hiroshi WATANABE ◽

Sadamu TAKAHASHI ◽

...

Keyword(s):

Total Gastrectomy ◽

Transcatheter Arterial Embolization ◽

Artery Aneurysm ◽

Arterial Embolization ◽

Pancreaticoduodenal Artery ◽

Abdominal Bleeding ◽

Pancreaticoduodenal Artery Aneurysm

Download Full-text

Case Report: Transcatheter Arterial Embolization for the Initial Management of Intra-Abdominal Hemorrhage From a Hepatic Tumor in a Cat

Frontiers in Veterinary Science ◽

10.3389/fvets.2021.707120 ◽

2021 ◽

Vol 8 ◽

Author(s):

Yuta Kawamura ◽

Hiroki Itou ◽

Akitomo Kida ◽

Hiroki Sunkawa ◽

Kenji Kawamura

Keyword(s):

Transcatheter Arterial Embolization ◽

Abdominal Mass ◽

Abdominal Cavity ◽

Good Condition ◽

Arterial Embolization ◽

Caudate Lobe ◽

Abdominal Ultrasonography ◽

Abdominal Bleeding ◽

Contrast Enhanced ◽

Enhanced Computed Tomography

An 8-year-old Ragdoll cat was admitted to our hospital after its owner noticed sudden lethargy. Abdominal ultrasonography showed a large amount of blood in the abdominal cavity, and the cat was diagnosed as having hemorrhagic shock caused by the rupture of an intra-abdominal mass. Blood transfusion was performed on the 1st day of hospitalization. On the 2nd day, contrast-enhanced computed tomography (CT) was performed, and hemorrhage from a mass originating in the caudate lobe of the liver was noted. Transcatheter arterial embolization (TAE) was performed to stop the bleeding from the mass using Gelpart to embolize the feeding artery. The following day, fever and elevation of liver enzyme levels were observed, but these subsided within a few days. At discharge 5 days after TAE, no fluid was found in the peritoneal cavity, and no further intra-abdominal bleeding occurred. Sixty-six days after TAE, we were able to perform resection surgery with the cat in good condition. A partial response was observed on CT performed before surgery. Histopathology revealed cholangiocellular adenoma. The cat was doing well as of postoperative day 549. This case indicates that TAE may be effective for initial hemostasis and stabilization of conditions in animals with tumor-induced hemorrhage.

Download Full-text