Nonvascular Interventions: The Gastrointestinal System

The interventional radiologist has a diverse and expanding role to play in the management and treatment of patients with disorders of the gastrointestinal (GI) system. These patients generally fall into one of two broad categories. The first category includes patients who are unable to tolerate or achieve adequate nutrition by mouth. In these patients, the interventional radiologist may be consulted to obtain percutaneous enteral access so that nutrition or hydration may be administered. The second category includes patients with benign or malignant strictures or obstruction of a hollow viscus, be it the esophagus, stomach, or small or large bowel. In these patients, the goal is to treat the obstruction when possible, or else decompress proximal to the obstruction for palliation of symptoms.

Gastrointestinal Tract: The Basics

The primary goal of this chapter is to provide an overview of the anatomy and physiology of the gastrointestinal (GI) tract, which will form the basis for the upcoming chapters on both vascular and nonvascular interventions. Normal, variant, and postsurgical findings will be discussed, and when pertinent, unique disease states as well. In addition, secretory enzymes and hormones will be discussed and their mechanism of action elucidated. The GI tract is responsible for the ingestion, digestion, and absorption of nutrients. Cumulatively, it receives the largest intra-abdominal blood supply. Understanding the anatomy, physiology, histology, and pathology of the GI tract is vital to the interventional radiologist in order to provide optimal patient treatment while avoiding complications.