Upper Gastrointestinal Upper Gastrointestinal Tract HemorrhageTract Hemorrhage

Zhengyu King

Content

• Overview

• Equipment, Material and method

• Clinical character

• Angiography

• Regional perfusion

• Local embolism

• Other

• Conclusion

Overview

• About gastrointestinal tract hemorrhage (GTH)

• Effective method for diagnosis of GTH

• Interventional treatment background of the GTH

• Clinical application

Equipment & Material

• Interventional operation room

• Equipment of the angiography

• Assistant appliance

• Special wire/catheter and relative material

• Drug and enbolization material

Methods

• Localization of the hemorrhage with selective angiography

• Specific method (magnify, induce, bleeding, charge)

• Super-selective catheter localization

• Regional perfusion or embolization

• Others

Others

• Equipment of emergency treatment

ECG/BP monitor oxygensuction apparatus

• Emergency step

transfusion, dilation, blood pressure

• Intra/post operation monitor

Clinical character

• vital sign(Blood pressure, heart rate)

• bleeding status: bleed volume

• intestinal tract, intra abdominal cavity

• primary etiology

Digestive Ulceration, post-operation ulceration,Disruption of the small artery at anastomotic stoma, instinal tract tumor, vessel malformation, trauma, hemorrhage of diverticulum

• conservative therapy

Selective angiography

• Method

• Indication

• Contraindication

• Pre-operation preparation

• Post-operation precautions

Selective angiography

• Super selective angiography

• Medication angiography

• Significance of angiography for surgery

• Artifice of angiography

• Limitation of angiography

Interventional therapy:Regional perfusion

• Indication

• Method

• Selection and application of appliance

• Selection and application of medicine

• Index for the treatment judgement

Interventional therapy:Regional perfusion

• Side-affect and complication

• Limitation of this method

• Precautions

• Remediation and timing

Interventional therapy:Local embolization

• Indications

• Selection of appliance

• Embolism material (dosage and selection)

• Method of local embolization treatment

• Monitor and judgement of the therapy efficacy

Interventional therapy:Local embolization

• Contraindications and complications

• Special locations

• Skill and experience

• Application and prospect of some new methods

Interventional therapy: others

• Diagnosis of non-arterial gastrointestinal hemorrhage

• Trans-cutaneous trans-hepatic portal vein intubatton

• TIPSS

• Endoscopy interventional treatment

Conclusion

Use of selective arterial angiography for diagnosis and treatment of arterial gastrointestinal hemorrhage is a simple, safe and fast emergency method. A specific hemostasis result can be achieved during this procedure, both with less complications. Diagnosis and treatment can be done at the same time.