Percutaneous embolotherapy of lower gastrointestinal hemorrhage

Abstract

Purpose: To evaluate percutaneous embolotherapy in the treatment of lower gastrointestinal hemorrhage.

Materials and methods: Twenty-one patients who underwent attempted percutaneous embolization for acute lower gastrointestinal bleeding between 1982 and 1997 were retrospectively studied. Hemorrhagic sites included jejunum (n = 4), ileum (n = 4), cecum (n = 4), and the remaining colon (n = 9).

Results: Embolization was not technically possible in four patients (19%). Hemostasis was achieved in 15 patients (71%) with prolonged hemostasis in 10 (48%). All embolizations distal to the cecum resulted in prolonged hemostasis. Three of four patients with jejunal bleeding had recurrent bleeding after apparent successful embolization. Only one of four cecal embolizations achieved prolonged cessation of bleeding. No ischemic complications were identified.

Conclusion: Based on these data, it would appear that the risk of bowel ischemia/infarction in the lower gastrointestinal tract may not be as high as has been suggested. Two regions (cecum and proximal jejunum) were associated with poor results, suggesting these areas may not be as responsive to embolotherapy as other sites in the lower gastrointestinal tract.