This is an automatically translated article.
Posted by Resident Doctor, Master Tran Duc Tuan - Department of Diagnostic Imaging - Vinmec Central Park International General Hospital
Gastrointestinal bleeding is a common medical emergency and can be life-threatening. Treatment methods for gastrointestinal bleeding are commonly used such as medical treatment, endoscopic intervention, digital scan to erase the background, and mesenteric vascular intervention.
1. In which cases are digital scans to erase the background and mesenteric vascular intervention indicated?
Mesenteric angiography visualizes these arteries and their terminal branches on digital subtraction angiography (DSA) screens. Angiography of the mesenteric arteries is often used in cases of non-tumor gastrointestinal bleeding or for endovascular intervention.
Indications for mesenteric artery intervention include:
Gastrointestinal bleeding not caused by varicose veins (usually in portal hypertension or hemorrhoids) that cannot be treated with medical therapy or endoscopic intervention. In some cases, it is necessary to diagnose vascular disease or vascular rich tumors that are not clear on computed tomography.
Chụp mạch mạc treo thường áp dụng trong xuất huyết tiêu hóa không do khối u hay để can thiệp nội mạch.
2. Contraindications of mesenteric vascular intervention method
There are no absolute contraindications. Relative contraindications in patients with coagulopathy, renal failure or allergy to contrast agents. In cases of severe gastrointestinal bleeding, the patient may be agitated or uncooperative, requiring anesthesia. It should be considered that in case the patient has stopped bleeding, except in the case of vascular lesions such as pseudoaneurysm, arterial dysplasia or arteriovenous catheterization (seen on computed tomography), intervention is necessary because there are risk of re-bleeding. Consider in case of pregnant women.
Gây mê được áp dụng với bênh nhân bị kích thích
3. Steps to take and intervene mesenteric vessels
The puncture site is usually the right femoral artery, in case the right femoral artery cannot be entered (stenosis - occlusion ...), it is possible to puncture the left femoral artery or the brachial artery. Catheter threading: Thread the catheter (cobra, sidewinder...) in combination with the guide wire to hook into the superior mesenteric artery and the inferior mesenteric artery. Perform an extended scan from the artery to the return of the mesenteric vein. Selective embolization: In case of detecting vascular injury causing gastrointestinal bleeding, use a microcatheter inserted into the lesion site and then block it with embolizing materials (hemostatic sponge, PVA, etc.) Hystoacryl, Metal spiral) depends on each lesion and the interventionist's experience. Often patients are intervened in an emergency due to gastrointestinal bleeding, so during the intervention, the patient's hemodynamic and respiratory status are monitored.
Immediately after the intervention, the patient is immobile at the hospital bed, especially the leg on the side of the puncture for at least 6 hours to monitor bleeding at the puncture site, monitor pulse, temperature, blood pressure, abdominal status, bleeding status digestive blood.
4. Possible complications after the intervention
Possible complications related to the intervention such as arterial dissection, bleeding at the puncture site or unwanted embolism.
In the case of using materials that cause embolism, especially using plastic beads, if there is a lot of reflux to the healthy branches, it can cause complications that cause intestinal infarction. In case of multiple infarcts, surgical resection of the infarcted bowel may be required.
Digital background removal is an imaging technique that requires professional expertise, and this technique must be performed at medical facilities with adequate facilities and systems. Modern machinery, standard photography room. Therefore, in order to achieve accurate imaging results, patients need to choose reputable addresses with digital background erasers and modern and standard medical equipment to perform. timely treatment.
Kỹ thuật chụp số hóa xóa nền tại Vinmec
Vinmec International General Hospital is a general hospital with the function of examining and treating pathological diseases, as well as providing emergency and lifesaving surgery for many difficult cases. At Vinmec, imaging has also been performed using digital imaging techniques to erase the background to detect many diseases as well as a premise to come up with a treatment regimen. The great success is because Vinmec is always fully equipped with modern facilities, examination and treatment procedures are carried out by a team of experienced and qualified doctors with many types of services. Perfect medical.
To register for medical examination and treatment at Vinmec International General Hospital, you can contact Vinmec Health System nationwide, or register online HERE.
