• Embolization
• Empirical embolization
• Hemobilia
• Hemosuccus pancreaticus
• Interventional radiology
• Prophylactic embolization
• Upper GI bleeding
• Variceal bleeding

• Humans
• Radiology, Interventional
• Treatment Outcome
• Gastrointestinal Hemorrhage/diagnostic imaging
• Gastrointestinal Hemorrhage/etiology
• Gastrointestinal Hemorrhage/surgery
• Endoscopy, Gastrointestinal
• Embolization, Therapeutic

• embolization
• gastrointestinal hemorrhage
• prognosis
• therapeutic

• Acute Disease
• Aged
• Aged, 80 and over
• Embolization, Therapeutic/adverse effects
• Embolization, Therapeutic/methods
• Female
• Gastrointestinal Hemorrhage/etiology
• Humans
• Male
• Middle Aged
• Prognosis
• Retrospective Studies
• Treatment Outcome

• chest tubes
• embolization
• hemorrhage
• interventional radiology
• thoracic
• trauma
• vascular injuries

• Cone-beam computed tomography
• Contrast-enhanced computed tomography
• Interventional radiology
• Three-dimensional imaging

Patients with acute nonvariceal gastrointestinal bleeding (GIB) not treatable via endoscopic therapy require angiography and endovascular management. If the source of the bleeding can be identified on angiography, the bleeding can be controlled with minimal complications by endovascular treatments such as intra-arterial infusion of vasopressin, embolization, covered stent placement, or a combination thereof. This pictorial essay reviews the angiographic findings for and the endovascular management of acute nonvariceal GIB.

Objective: To report the safety and efficacy of trans-arterial embolization (TAE) for upper gastrointestinal bleeding (UGIB) and lower gastrointestinal bleeding (LGIB) due to different etiologies in 91 patients for ten years. Methods: A retrospective analysis of GIB treated between January 2010 and December 2020 was performed. TAE was performed using different embolic agents (coils, particles, glue, gelatin sponge, and EVOH-based agents). Technical success, secondary technical success, clinical success, and complications were evaluated. Results: Technical success was achieved in 74/91 (81.32%) patients. Seventeen patients (18.68%) required re-intervention. Secondary technical success was achieved in all cases (100.0%). Clinical success was achieved in 81/91 patients (89.01%). No major complications were recorded; overall, minor complications occurred in 20/91 patients. Conclusions: TAE is a technically feasible and safe therapeutic option for patients with GIB from a known or blind anatomic source where endoscopic therapy has failed or is deemed unfeasible.

• embolic agents
• gastrointestinal bleeding
• trans-arterial embolization

• Device assisted enteroscopy
• Iron deficiency Anemia (IDA)
• Iron therapy
• Obscure gastrointestinal bleeding
• Occult gastrointestinal bleeding
• Video capsule endoscopy

• Anemia, Iron-Deficiency/diagnosis
• Anemia, Iron-Deficiency/etiology
• Anemia, Iron-Deficiency/therapy
• Capsule Endoscopy
• Gastrointestinal Hemorrhage/diagnosis
• Gastrointestinal Hemorrhage/etiology
• Gastrointestinal Hemorrhage/therapy
• Humans
• Intestine, Small

This study analyzed the clinical results of palliative radiotherapy for bleeding control in patients with unresectable advanced gastric cancer.

We retrospectively reviewed the medical records of patients who met the following inclusion criteria between January 2002 and June 2018: histologically proven gastric cancer, gastric tumor bleeding confirmed by upper gastrointestinal endoscopy, and palliative radiotherapy performed for hemostasis. The median radiotherapy dose was 30 Gy, with a daily dose ranging from 1.8 to 3 Gy.

Sixty-one patients were included in this analysis. The study population was predominantly male (72.1%), with a median age of 62 years (range: 32–92). The median baseline hemoglobin level was 7.1 g/dL, and the most common presenting symptom of gastric tumor bleeding was melena (85.2%). Bleeding control was achieved in 54 (88.5%) patients. The median levels of hemoglobin at 1, 2, and 3 months after completion of radiotherapy were 10.1 g/dL, 10.2 g/dL, and 10.4 g/dL, respectively; these values were significantly different from that before radiotherapy (7.1 g/dL; p < 0.001). The median overall survival was 4.8 months. Among the 54 patients who achieved bleeding control after radiotherapy, 19 (35.2%) experienced re-bleeding during the follow-up period. The median time to re-bleeding was 6.0 months. Multivariate analysis demonstrated that a higher radiation dose (p = 0.007) and additional chemotherapy after radiotherapy (p = 0.004) were significant factors for prolonging the time to re-bleeding.

Tumor bleeding was adequately controlled by radiotherapy in patients with unresectable advanced gastric cancer.

• Chemotherapy
• Hemorrhage
• Hemostasis
• Radiotherapy
• Stomach neoplasm

• Acute Disease
• Aged
• Angiography, Digital Subtraction
• Anticoagulants/adverse effects
• Cause of Death
• Critical Care
• Embolization, Therapeutic/methods
• Embolization, Therapeutic/mortality
• Erythrocyte Transfusion/statistics & numerical data
• Female
• Hemoglobin A/analysis
• Humans
• Iatrogenic Disease
• Male
• Middle Aged
• Postoperative Hemorrhage/blood
• Postoperative Hemorrhage/mortality
• Postoperative Hemorrhage/therapy
• Retrospective Studies
• Treatment Outcome

• Angiodysplasia
• Arteriovascular malformations
• Ileal resection
• Telangectasia

• Gastrointestinal bleeding
• computed tomography angiography (CTA)
• conventional angiography (CA)
• scintigraphy

To analyze causes of acute nonvariceal gastrointestinal bleeding (GIB) with negative digital subtraction angiography (DSA) results.

The clinical and follow-up data of 133 patients - recruited between February 2008 and November 2016 - with acute nonvariceal GIB and negative DSA results were included in this study. DSA results, diagnoses, and clinical outcomes were recorded.

The DSA results were negative in all 133 patients. Of the total, 55 patients (41.4%) chose to undergo surgery and 78 (58.6%) opted for conservative treatment. Within 30 days, there was no significant difference in the rebleeding or mortality rates between the two groups (P < .05). Of all 133 patients, 76 (57.1%) had upper GIB and 57 (42.9%) had lower GIB; within 30 days, the rebleeding rate in the upper GIB group (44.7%, 34/76) was significantly higher than that in the lower GIB group (26.3%, 15/57). There was no significant statistical difference (P < .05) within 30 days in the mortality rates between the two groups.

Among patients with upper GIB, 26 (34.2%, 26/76) opted to undergo surgery and 50 (65.8%, 50/76) chose conservative treatment; within 30 days, the rebleeding rate in the group that chose surgery (61.5%, 16/26) was higher than that in the conservative treatment group (36%, 18/50). There was no significant difference (P < .05) within 30 days in the mortality rate between the two groups.

Among the patients with lower GIB, 29 (50.9%, 29/57) chose to undergo surgery and 28 (49.1%, 28/57) opted for conservative treatment. Within 30 days, the rebleeding rate in the surgery group (13.8%, 4/29) was lower than that in conservative treatment group (39.3%, 11/28). There was no significant difference (P < .05) within 30 days in the mortality rate between the two groups.

Sixteen patients underwent prophylactic arterial embolization; in 6 of these, bleeding was stopped for 30 days. DSA was then repeated in these 16 patients after a median interval of 1 day, and a positive bleeding site was found in 9 of the 16. Causes of bleeding were found in 111 patients by surgery or endoscopy, whereas the causes remained unknown in 22 patients.

Upper GIB with negative DSA results was stopped by conservative treatment, whereas lower GIB required surgery to detect the culprit bleeding site. Rare causes of GIB should be considered and appropriate management selected in a timely manner in order to detect unusual causes.

• Angiography
• Embolization, therapeutic
• Gastrointestinal hemorrhage

• Acute
• Angiography
• Bleed
• Enterography
• Gastrointestinal
• Lower
• Occult
• Radiology

• Angiography
• Embolization, therapeutic
• Gastrointestinal hemorrhage

• Arterial
• Embolic agents
• Embolization
• Hemorrhage
• Interventional radiology
• Nonvariceal upper gastrointestinal bleeding

• Argon plasma coagulation
• capsule endoscopy
• double balloon enteroscopy
• serum biomarkers
• small bowel angioectasias
• somatostatin analogues
• thalidomide

• colonic bleeding
• vascular embolization

• acute arterial massive hemorrhage
• gastrointestinal
• transcatheter arterial embolization

• Acute Disease
• Adolescent
• Adult
• Aged
• Angiography
• Embolization, Therapeutic
• Emergencies
• Endovascular Procedures
• Female
• Gastrointestinal Hemorrhage/diagnostic imaging
• Gastrointestinal Hemorrhage/etiology
• Gastrointestinal Hemorrhage/therapy
• Humans
• Male
• Middle Aged
• Retrospective Studies
• Treatment Outcome
• Young Adult

• Lower gastrointestinal bleeding
• angiography
• colonoscopy
• diverticular bleeding
• endoscopy

Endoscopic methods (gastroscopy and colonoscopy) are considered fundamental for the diagnosis of gastrointestinal bleeding. In recent years, multidetector computed tomography (MDCT) has also gained importance in diagnosing gastrointestinal bleeding, particularly in hemodynamically unstable patients and in cases with suspected lower gastrointestinal tract bleeding. CT can detect both the source and the cause of active gastrointestinal bleeding, thereby expediting treatment initiation.

The study group consisted of 16 patients with clinical symptoms of gastrointestinal bleeding in whom features of active bleeding were observed on CT. In all patients, bleeding was verified by means of other methods such as endoscopic examinations, endovascular procedures, or surgery.

The bleeding source was identified on CT in all 16 patients. In 14 cases (87.5%), bleeding was confirmed by other methods.

CT is an efficient, fast, and readily available tool for detecting the location of acute gastrointestinal bleeding.

• Endoscopes, Gastrointestinal
• Endovascular Procedures
• Gastrointestinal Hemorrhage
• Multidetector Computed Tomography

• colonic bleeding
• endoscopic hemostasis
• vascular embolization

• Active hemorrhage
• trauma
• endovascular treatment
• computed tomography
• digital subtraction angiography

• AUC
• Appropriate Use Criteria
• Appropriateness Criteria
• CTA
• GIB
• Tc-99m-labeled RBC scan
• angiography
• nonvariceal upper gastrointestinal bleeding

Acute upper and lower gastrointestinal bleeding, enteral feeding, cecostomy tubes and luminal strictures are some of the common reasons for gastroenterology service. While surgery was initially considered the main treatment modality, the advent of both therapeutic endoscopy and interventional radiology have resulted in the paradigm shift in the management of these conditions. In this paper, we discuss the patient’s work up, indications, and complementary roles of endoscopic and angiographic management in the settings of gastrointestinal bleeding, enteral feeding, cecostomy tube placement and luminal strictures. These conditions often require multidisciplinary approaches involving a team of interventional radiologists, gastroenterologists and surgeons. Further, the authors also aim to describe how the fields of interventional radiology and gastrointestinal endoscopy are overlapping and complementary in the management of these complex conditions.

• Gastrointestinal hemorrhage
• Enteral nutrition
• Interventional radiology
• Gastroenterology
• Endoscopy

• Angiography
• Embolization
• Gastrointestinal bleeding
• Gastrointestinal lymphoma

• Colonoscopy
• Endoscopy
• GI angiography
• GI bleeding
• GI haemorrhage
• Haematochezia
• Lower GI

Crohn's Disease (CD) is a chronic granulomatous inflammatory disorder of the gastrointestinal tract. With the change of the life style and the progress of the diagnosis method, the number of patients diagnosed with CD has increased in China. In the course of disease development, some patients may have intestinal obstruction, abdominal abscess, acute perforation, gastrointestinal bleeding or other complications. Massive lower gastrointestinal hemorrhage is not a common complication of CD, and is a challenge for diagnosis and therapeutic management. It is more difficult to diagnose and treat CD associated lower digestive tract hemorrhage, compared with massive hemorrhage of lower digestive tract caused by other reasons. This paper reviews recent advances in the diagnosis and management of CD complicated with severe lower gastrointestinal hemorrhage.

• Crohn's disease
• Gastrointestinal hemorrhage
• Diagnosis
• Complication

• Bleeding
• Blunt chest trauma
• Internal mammary artery injury
• Treatment

AIM: To evaluate the diagnostic value of upper digestive tract radiography in children with congenital hypertrophic pyloric stenosis.

METHODS: Clinical data for 88 children with congenital hypertrophic pyloric stenosis treated at Wuhan Medical Care Center for Women and Children Hospital from January 2012 to January 2014 were retrospectively analyzed. Upper digestive tract radiography was performed preoperatively in all the patients.

RESULTS: Of the 88 children, 40 (45.45%) had shoulder-like symptoms, 16 (18.18%) had nipple sign, 40 (45.45%) had line-like sign, 20 (22.72%) had pileus sign, 29 (32.95%) had beak sign, and 30 (34.09%) had tram line sign. Upper digestive tract radiography showed that pyloric duct diameter was 15.1 mm ± 0.80 mm, pyloric duct length 22.1 mm ± 2.04 mm, and pyloric muscle thickness 5.2 mm ± 0.61 mm. Intraoperatively measured pyloric tube measured pyloric duct diameter was 15.5 mm ± 0.71 mm, pyloric duct length 23.1 mm ± 2.15 mm, and pyloric muscle thickness 4.7 mm ± 0.69 mm, which were significantly different from those measured by radiography (P < 0.05).

CONCLUSION: Upper gastrointestinal tract radiography has very important diagnostic significance in children with congenital hypertrophic pyloric stenosis.

• Children
• Congenital hypertrophic pyloric stenosis
• Upper gastrointestinal radiography

Gastrointestinal bleeding is a common problem encountered in the emergency department and in the primary care setting. Acute or overt gastrointestinal bleeding is visible in the form of hematemesis, melena or hematochezia. Chronic or occult gastrointestinal bleeding is not apparent to the patient and usually presents as positive fecal occult blood or iron deficiency anemia. Obscure gastrointestinal bleeding is recurrent bleeding when the source remains unidentified after upper endoscopy and colonoscopic evaluation and is usually from the small intestine. Accurate clinical diagnosis is crucial and guides definitive investigations and interventions. This review summarizes the overall diagnostic approach to gastrointestinal bleeding and provides a practical guide for clinicians.

• Gastrointestinal hemorrhage
• Diagnostic techniques
• Endoscopy
• Colonoscopy
• Capsule endoscopy
• Enteroscopy
• Computed tomography
• Angiography

• Angiography
• Embolization
• Enterography
• Enteroscopy
• Gastrointestinal bleeding
• Scintigraphy