Aim: To evaluate the efficacy and safety of emergency transcatheter arterial embolization (ETAE) for patients with acute massive duodenal ulcer hemorrhage.
Methods: Twenty-nine consecutive patients with acute massive bleeding of duodenal ulcer were admitted to our hospital from 2006 to 2011. Superselective angiography of the celiac and gastroduodenal arteries was performed to find out the bleeding sites before ETAE, then, embolotherapy was done with gelatin sponge particles or microstrips via a 5 French angiographic catheter or 3 French microcatheter. After ETAE, further superior mesenteric arteriography was undertaken in case collateral circulation supplied areas of the duodenal ulcer. Technical and clinical success rates were analyzed. Changes in the mucous membrane were observed using endoscopy following ETAE.
Results: Angiography showed active bleeding with extravasation of contrast medium in seven cases with a 24% positive rate of celiac artery bleeding, and in 19 cases with a 65.5% rate of gastroduodenal artery bleeding. There were no angiographic signs of bleeding in three patients who underwent endoscopy prior to ETAE. Twenty-six patients achieved immediate hemostasis and technical success rate reached 90%. No hemostasis was observed in 27 patients within 30 d after ETAE and clinical success rate was 93%. Recurrent hemorrhage occurred in two patients who drank a lot of wine who were treated by a second embolotherapy in the same way. Five patients underwent transient ischem with light abdominal pain under xiphoid, spontaneous restoration without special treatment. No mucous necrosis happened to 29 cases for ischem of gastroduodenal arteries embolized.
Conclusion: ETAE is an effective and safe measure to control acute massive bleeding of duodenal ulcer.
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http://dx.doi.org/10.3748/wjg.v18.i34.4765 | DOI Listing |
Rev Esp Enferm Dig
January 2025
Cirugía General y del Aparato Digestivo, Hospital Universitario 12 de Octubre.
Case report of a patient with a duodenal ulcer, initially treated with sclerosing agents, as is common practice for most bleeding ulcers. However, the evolution following this treatment is unusual. The patient developed secondary ischemic cholangitis, leading to extensive aerobilia and secondary portal pneumatosis, accompanied by inflammatory changes in the head of the pancreas.
View Article and Find Full Text PDFMorphologie
January 2025
Department of Digestive Surgery, Amiens Picardy University Hospital, 1, rondpoint du Pr-Cabrol, 80054 Amiens, France; Simplifying Care for Complex Patients, UR-UPJV 7518 SSPC, Clinical Research Unit, University of Picardie Jules-Verne, Amiens, France.
Introduction: The duodeno-pancreatic region is a highly vascularized area. The superior and posterior pancreaticoduodenal artery is a vessel primarily originating from the gastroduodenal artery. It exhibits rare anatomical variations, such as its emergence from the right branch of the hepatic artery, which we fortuitously identified during a cadaver dissection.
View Article and Find Full Text PDFCureus
November 2024
Community and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, IND.
Duodenal perforation often presents as an acute onset of abdominal pain and potential complications such as systemic infection, multiple organ system failure, and even death. It can result from various causes, including peptic ulcer disease (PUD), trauma, malignancies, and infections. Prompt diagnosis and timely intervention are critical for better outcomes, though mortality can be high, particularly in delayed cases.
View Article and Find Full Text PDFCureus
November 2024
Accident and Emergency, Pilgrim Hospital, United Lincolnshire Hospitals Trust, Boston, GBR.
Epigastric pain and vomiting are common presentations associated with various causes of acute abdomen. Acute abdomen encompasses a range of different pathologies, with epigastric pain narrowing the differential diagnosis to conditions such as pancreatitis, bowel obstruction, acute cholecystitis, gastritis, acute coronary syndrome (ACS), and peptic ulcer disease, such as gastric ulcers and duodenal ulcers with/without perforation. This is a case of a male patient in his 80s who came to the emergency department with symptoms of generalized abdominal pain, vomiting, and constipation.
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