Embolotherapy in Acute Arterial Gastrointestinal Hemorrhage

After the presentation of the first patient treated by embolization 1970, the authors present potential sources of gastrointestinal (GI) bleeding. The acutely bleeding patients need to have first endoscopic evaluation and eventual treatment. Diagnostic angiography is then described. Embolization with occlusion of the bleeding vessel is presently the preferred approach by most interventionalists. Depending on their preference and size of the bleeding vessel, interventionalists use particles of Gelfoam sponge or polyvinyl alcohol foam, coils, or liquid agents as N-butyl cyanoacrylate for embolization. Characteristics of agents are described, and examples are presented. In extra-alimentary sources of GI bleeding, hemobilia and bleeding from pancreas and fistulas with aorta and major arteries are discussed, and embolotherapy approaches are suggested.