Transcatheter Embolization for Treatment of Acute Lower Gastrointestinal Bleeding

1987 ◽  
Vol 28 (4) ◽  
pp. 425-430 ◽  
Author(s):  
R. Uflacker
Keyword(s):  
Gastrointestinal Bleeding ◽  
Transcatheter Embolization ◽  
Lower Gastrointestinal Bleeding ◽  
Mesenteric Arteries ◽  
Middle Colic Artery ◽  
Colic Artery ◽  
Selective Embolization ◽  
Diverticular Hemorrhage ◽  
Carcinoma Of The Bladder ◽  
The Right

Treatment of lower gastrointestinal bleeding was attempted in 13 patients by selective embolization of branches of the mesenteric arteries with Gelfoam. Bleeding was adequately controlled in 11 patients with active bleeding during the examination. One patient improved after embolization but bleeding recurred within 24 hours and in another patient the catheterization was unsuccessful. Five patients with diverticular hemorrhage were embolized in the right colic artery four times, and once in the middle colic artery. Three patients had embolization of the ileocolic artery because of hemorrhage from cecal angiodysplasia, post appendectomy, and leukemia infiltration. Three patients had the superior hemorrhoidal artery embolized because of bleeding from unspecific proctitis, infiltration of the rectum from a carcinoma of the bladder, and transendoscopic polypectomy. One patient was septic and bled from jejunal ulcers. Ischemic changes with infarction of the large bowel developed in two patients and were treated by partial semi-elective colectomy, three and four days after embolization. Four other patients developed pain and fever after embolization. Transcatheter embolization of branches of mesenteric arteries is an effective way to control acute lower gastrointestinal bleeding, but still has a significant rate of complications that must be seriously weighed against the advantages of operation.

Stenting of stenotic mesenteric arteries for symptomatic chronic mesenteric ischemia

VASA ◽  
2012 ◽  
Vol 41 (6) ◽  
pp. 425-431 ◽  
Author(s):  
Aschenbach ◽  
Bergert ◽  
Kerl ◽  
Zangos ◽  
Neumeister ◽  
...  
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Gastrointestinal Bleeding ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Celiac Artery ◽  
Lower Gastrointestinal Bleeding ◽  
Mesenteric Arteries ◽  
Chronic Mesenteric Ischemia ◽  
Technical Failure

Background: We report the results of our single center series of patients with chronic mesenteric ischemia (CMI) to determine the role of stenting in the management of patients. Patients and methods: We retrospectively reviewed all patients with CMI treated endovascularly with stent revascularisation from January 2008 to January 2011.CMI diagnosis was made according to clinical symptoms, including postprandial abdominal pain, food fear, and weight loss. Additionally, the diagnosis was confirmed by duplex ultrasonography and/or computed tomography angiography and/or contrast-enhanced magnetic resonance angiography. Results: All 45 patients presented with typical CMI symptoms: 45/45 (100 %) had postprandial pain, 31/45 (68.8 %) had a weight loss of more than 10 kilograms, and 11/45 (24.4 %) suffered from ischemic colitis combined with lower gastrointestinal bleeding. In three patients occlusion could not be crossed, therefore considered as technical failure. A total of 55 arteries were stented in the remaining 42 patients. Nineteen patients underwent SMA stenting alone, eight underwent celiac stenting, alone and three patients underwent stenting of inferior mesenteric artery (IMA) alone. We performed combined stenting of the celiac artery and superior mesenteric artery in ten patients, and one patient underwent a combined stenting of the celiac artery and the IMA. All three mesenteric arteries were stented in only one patient. Primary technical success was achieved in 42/45 (94.8 %) patients. Clinical symptom relief was achieved in 39/45 (86.6 %) patients with abdominal pain. Increased body weight was observed in 28/31 (90.3 %) patients with an average weight gain of 8.8 kilograms (5 - 12 kilograms), and 10/11 (90.9 %) patients recovered from ischaemic colitis/lower gastrointestinal bleeding. Conclusions: Stent revascularisation can be considered as the first-line therapy for patients with chronic mesenteric ischemia.

scholarly journals Anatomical study on origin, course and distribution of cranial and caudal mesenteric arteries in the White New Zealand rabbit (Orycotolagus cuniculus)

2012 ◽  
Vol 2 (2) ◽  
pp. 54-59 ◽  
Author(s):  
M Uddin ◽  
ML Rahman ◽  
MA Alam ◽  
ASML Ahasan
Keyword(s):  
New Zealand ◽  
Abdominal Aorta ◽  
Transverse Colon ◽  
Mesenteric Artery ◽  
Mesenteric Arteries ◽  
Middle Colic Artery ◽  
Colic Artery ◽  
Left Wall ◽  
Zealand Rabbit ◽  
Descending Colon

The present study was carried out on fifteen healthy adult White New Zealand rabbit (Orycotolagus cuniculus) to clarify the obscure mesenteric arteries, which and their branches which are usually involved in intestinal surgery. The mesenteric artery is a high caliber vessel, 2cm in length dependent on the abdominal aorta, right below the emergence of the vessels destined for the liver and stomach. The animals were sacrificed, injecting diazepam (30 mg/kg) in jugular vein. Cannulation of the abdominal aorta, perfusion with warmed water (40ºC) and stained latex injection (Neoprene 450, Capitol Scientific, Austin, U.S.A, Red carmine stain) were performed, followed by fixation. With formalin (10%) the dissection and photographic documents (Casio Cyber-shot, 12.1 mega pixels) made it possible to systemize the arteries and define the vascular patterns of the viscera. The results prone that the cranial mesenteric artery of the White New Zealand rabbit (Orycotolagus cuniculus) arose from the abdominal aorta, at the level of the second lumbar vertebra, entered the cranial mesentery forming its root, then proceeded caudoventrally in the mesojejunum and continued as the last cecal artery. The cranial mesenteric artery gave off: - Caudal pancreaticoduodenal artery to the right lobe of the pancreas and the descending and ascending parts of the duodenum. Middle colic artery, a small vessel (frequently two) arising from the left wall and passing to the transverse colon, Eighteen to twenty jejunal arteries, Ileocecocolic artery to the ileum, cecum, ascending colon, transverse colon and the cranial part of the descending colon. The caudal mesenteric artery arose from the abdominal aorta at the level of the caudal border of the root of the 6th lumbar transverse process, passed caudoventrally in the descending mesocolon, then divided into: left colic artery to the caudal two thirds of the descending colon, and cranial rectal artery to the cranial segment of the rectum. The obtained results were compared with their corresponding in the domestic animals, especially the domestic carnivores and laboratory animals. DOI: http://dx.doi.org/10.3329/ijns.v2i2.11386 International Journal of Natural Sciences (2012), 2(2):54-59

Role of super-selective embolization in lower gastrointestinal bleeding

2018 ◽  
Vol 88 (9) ◽  
pp. E644-E648 ◽  
Author(s):  
Sajith C. Senadeera ◽  
Simon V. Vun ◽  
Nicholas Butterfield ◽  
Tim W. Eglinton ◽  
Frank A. Frizelle
Keyword(s):  
Gastrointestinal Bleeding ◽  
Lower Gastrointestinal Bleeding ◽  
Selective Embolization

scholarly journals The right colic artery: An anatomical demonstration and its relevance in the laparoscopic era

2016 ◽  
Vol 98 (8) ◽  
pp. 560-563 ◽  
Author(s):  
M Haywood ◽  
C Molyneux ◽  
V Mahadevan ◽  
J Lloyd ◽  
N Srinivasaiah
Keyword(s):  
Complete Mesocolic Excision ◽  
Middle Colic Artery ◽  
Colic Artery ◽  
Right Colon ◽  
Early Evidence ◽  
Mesocolic Excision ◽  
Tissue Act ◽  
Human Tissue Act ◽  
The Right ◽  
Laparoscopic Techniques

INTRODUCTION Hemicolectomies are not tailored in right-sided colon cancer resections, despite significant variation in the incidence and origin of the right colic artery (RCA). Early evidence suggests that removal of the relevant lymphovascular package and associated cancer as part of complete mesocolic excision (CME), rather than the entire right colon, may produce better outcomes. Advancing laparoscopic techniques are making this possible, and so it is increasingly important to more precisely define the anatomy of the RCA. METHODS To demonstrate the incidence and variation of the RCA, 25 formalin embalmed cadavers were dissected. Consent to dissection and photography was obtained under Human Tissue Act regulations. RESULTS Eleven female and 14 male cadavers (mean age 79.7 years, range 41–95 years) were included. The RCA originated from the right branch of the middle colic artery in nine cadavers (36%), while it arose from the superior mesenteric artery in eight cases (32%) and from the ileocolic or root of the middle colic artery in a smaller number of specimens. The RCA was absent in two individuals. CONCLUSIONS The RCA arises from the right branch of the middle colic artery in a considerable number of cases. The literature to date does not reflect the precision of anatomical understanding required for CME; hence, a new definition for the right colic vessel is proposed.

scholarly journals COMPLETE THORACIC ESOPHAGUS OBLITERATION: CLINICAL CASE REPORT

2021 ◽  
Vol 74 (1) ◽  
pp. 155-160
Author(s):  
Serhii O. Savvi ◽  
Alla Yu. Korolevska ◽  
Serhii Yu. Bityak ◽  
Yevhen A. Novikov
Keyword(s):  
Surgical Treatment ◽  
Chest Wall ◽  
Esophageal Stricture ◽  
Clinical Case ◽  
Middle Colic Artery ◽  
Thoracic Esophagus ◽  
Colic Artery ◽  
Treatment Results ◽  
Food Passage ◽  
The Right

Using the example of a clinical case, to present the management features of a patient with complete esophageal obliteration as a chemical burn result, the surgical intervention features in case of a non-standard situation during the operation, and the treatment results analyze. It was described a clinical case of 41-year-old patient with thoracic esophagus obliteration due to extended post-burn cicatricial esophageal stricture, dysphagia of IV degree in very severe general condition. Stamm-Senn-Kader’s gastrostomy was performed as a first step of surgical treatment. Angiography and embolization of the right colic artery and it’s branches was performed in 8 months while preserving the middle colic artery. In 20 days the cologastroanastomosis and feeding colostomy on the right chest wall were performed. In 10 days after the colostomy was disattached from the chest wall, the end-to-side esophagocoloanastomosis was performed intrapleurally. In one month after the third surgery and restoration of the food passage by the natural way, closure of the contact gastrostomy was performed. During the observation over the patient (8 years) the postoperative complications were not observed. The patient survived. The proposed staged surgical treatment tactics of patients with complete esophageal obliteration due to post-burn esophageal stricture, dysphagia of IV degree presents effective treatment results and a significant improvement in the patient’s life quality.

The Efficacy and Durability of Super-Selective Embolization in the Treatment of Lower Gastrointestinal Bleeding

2008 ◽  
Vol 51 (3) ◽  
pp. 301-305 ◽  
Author(s):  
T. Lipof ◽  
W. V. Sardella ◽  
C. M. Bartus ◽  
K. H. Johnson ◽  
P. V. Vignati ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Lower Gastrointestinal Bleeding ◽  
Selective Embolization

Microballoon Occlusion Test to Predict Colonic Ischemia After Transcatheter Embolization of a Ruptured Aneurysm of the Middle Colic Artery

2008 ◽  
Vol 31 (4) ◽  
pp. 828-832 ◽  
Author(s):  
Tsuyoshi Tajima ◽  
Kengo Yoshimitsu ◽  
Hiroyuki Inokuchi ◽  
Hiroyuki Irie ◽  
Akihiro Nishie ◽  
...  
Keyword(s):  
Transcatheter Embolization ◽  
Ruptured Aneurysm ◽  
Middle Colic Artery ◽  
Colic Artery ◽  
Colonic Ischemia ◽  
Occlusion Test

scholarly journals Course and Variations in Branches of Inferior Mesenteric Artery

2021 ◽  
Vol 9 (1) ◽  
pp. 17-20
Author(s):  
Prerna Gupta ◽  
Neeraj Gupta
Keyword(s):  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Mesenteric Arteries ◽  
Middle Colic Artery ◽  
Type I ◽  
Colic Artery ◽  
Male Fetus ◽  
Male Adult ◽  
Female Fetus ◽  
Study Results

Background : The mesenteric blood supply is a combination of rich collateral networks. There are frequent anatomical variants encountered and these variations are sometimes involved in pathologies. Treatment of which requires a better understanding of the variations in the normal anatomy of the inferior mesenteric artery. Methods : The present study was carried out in the Department of Anatomy, Prathima Institute of Medical Sciences, Karimnagar. A total of n=50 specimens, with n=17 adult males and n=2 adult female cadavers and fetuses of which n=26 were term and n=2, was preterm. Female fetuses n=2 of term and n=1 preterm were included in the study. Results : The following variations were observed in the present study of course and variations in the branches of the inferior mesenteric artery and are grouped into three types. Type I: In this type middle colic artery is arising from the inferior mesenteric artery instead of the superior mesenteric artery. It is a rare-variations and observed in a female fetus. Type-II: Four Sigmoidal arteries are arising from an inferior mesenteric artery, after the origin of the left colic artery. This type is observed in a male fetus. Type-III: Three Sigmoidal arteries are originated from the inferior mesenteric artery. This type was observed in a male adult and a male fetus. Conclusion: Out of the 50 cases included in the study we found type 1 variation of IMA in 2% of cases, type 2 variation was found in 2% samples, and type 3 variation was found in 4% of samples. Based on the variations radiologists and Surgeons should be aware of possible consequences when doing colectomy, right hemicolectomy, left hemicolectomy, sigmoidectomy, en-bloc resection of the head of the pancreas, aneurysm, and chronic bowel ischemia. The present study is also useful for reconstructive surgeries in inferior mesenteric arteries in the case of ischemia.

scholarly journals Three-Dimensional Vascular Anatomy Relevant to Oncologic Resection of Right Colon Cancer

2011 ◽  
Vol 96 (4) ◽  
pp. 300-304 ◽  
Author(s):  
Yusuke Tajima ◽  
Hideyuki Ishida ◽  
Tomonori Ohsawa ◽  
Kensuke Kumamoto ◽  
Keiichiro Ishibashi ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Three Dimensional ◽  
Vascular Anatomy ◽  
Middle Colic Artery ◽  
Common Trunk ◽  
Colic Artery ◽  
Right Colon ◽  
Right Colon Cancer ◽  
Oncologic Resection ◽  
The Right

Abstract We analyzed data on the three-dimensional vascular anatomy of the right colon from the operative documents of 215 patients undergoing oncologic resection for right colon cancer. The right colic artery (RCA) was absent in 146 patients (67.9%), with the ileocolic artery (ICA) crossing the superior mesenteric vein (SMV) ventrally in 78 patients (36.3%). When the RCA was present, both the ICA and the RCA crossed the SMV ventrally in 44 patients (20.5%), dorsally in 10 patients (4.7%), the RCA crossed the SMV ventrally and the ICA dorsally in 10 patients (4.7%), and the RCA crossed the SMV dorsally and the ICA ventrally in 5 patients (2.2%). The arterial branches toward the hepatic flexure crossed the SMV ventrally in 151 eligible cases: the branch originated from the common trunk of the middle colic artery in 97 patients (64.2%) and 1 and 2 arteries directly originated from the SMA in 49 patients (32.5%) and in 5 patients (3.3%), respectively. These data would be useful to safely perform lymph node dissection around the SMV.

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