Today’s case 13 – Embolization for GI bleeding

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Today’s case 13 – Embolization for GI bleeding

Today, I will discuss a classic case of upper gastrointestinal bleeding that I treated myself.

The patient presented to the Emergency Room (ER) due to melena, which occurred earlier that day.

A dynamic contrast-enhanced computed tomography (CT) scan revealed contrast extravasation in the stomach.

An ER resident referred the patient to our department for the treatment of upper GI bleeding.

Embolization for GI bleeding
On the CT, contrast extravasation suggesting active bleeding was identified at the lesser curvature of the gastric body.
Angiography was performed on the left gastric artery. However, no definite active bleeding was observed during the angiography.

Despite this, the active bleeding indicated on the CT was clear.

Therefore, I suspected that the active bleeding was masked during the left gastric artery angiography due to its proximity to the source.

Consequently, I opted to perform selective angiography on a more distal branch using a microcatheter. Finally, contrast extravasation was observed on the selective angiography (indicated by the arrow)
The microcatheter was advanced, targeting the suspected culprit artery. Subsequently, selective angiography was performed to confirm whether it was indeed the culprit artery. And yes, it was confirmed as the culprit artery
Therefore, I performed embolization using a glue/Lipiodol (1:3) mixture

The patient’s vital signs and symptoms immediately improved, and the patient was subsequently discharged

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