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Angiography in GI BleedingAka: Arteriography in Gastrointestinal Bleeding

Indications
1. Identification of Gastrointestinal Bleeding site
2. Preoperative evaluation for occult GI Bleeding source
3. Criteria may include
  1. Early positive Tagged Red Cell Scan
  2. Frequent blood transfusion required
  3. Hemodynamic compromise
Efficacy
1. Not as sensitive for active bleeding as tagged scan
  1. Identifies bleeding only if >0.5 ml/min
  2. Tagged cell scan used to preselect for angiography
2. May identify non-bleeding lesion
  1. Tumors
  2. Angiodysplasia
3. Best localizes bleeding (tagged cell scan inaccurate)
Management: Modalities to control bleeding
1. Intra-arterial vasopressin infusion
  1. Risk of Myocardial Ischemia and arrhythmias
  2. Rebleeding rate: 50%
2. Transcatheter embolization
  1. Risk of intestinal infarction
Complications (Complication rate 9.3%)
1. Acute Renal Failure (Acute Tubular Necrosis)
  1. See Intravenous Contrast Related Acute Renal Failure
2. IV Contrast reaction
3. Transient Ischemic Attack
4. Insertion site hematoma
5. Femoral artery thrombosis

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.