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Incidence and management of bleeding complications following percutaneous radiologic gastrostomy

Authors
 Nieun Seo  ;  Ji Hoon Shin  ;  Gi-Young Ko  ;  Hyun-Ki Yoon  ;  Dong-Il Gwon  ;  Jin-Hyoung Kim  ;  Kyu-Bo Sung 
Citation
 Korean Journal of Radiology, Vol.13(2) : 174-181, 2012 
Journal Title
 Korean Journal of Radiology 
ISSN
 1229-6929 
Issue Date
2012
MeSH
Adult ; Aged ; Aged, 80 and over ; Embolization, Therapeutic/methods* ; Female ; Gastrointestinal Hemorrhage/diagnosis ; Gastrointestinal Hemorrhage/epidemiology* ; Gastrointestinal Hemorrhage/therapy* ; Gastrostomy* ; Humans ; Incidence ; Male ; Middle Aged ; Postoperative Hemorrhage/diagnosis ; Postoperative Hemorrhage/epidemiology* ; Postoperative Hemorrhage/therapy* ; Retrospective Studies ; Time Factors ; Treatment Outcome
Keywords
Bleeding ; Percutaneous radiologic gastrostomy ; Transcatheter arterial embolization
Abstract
Objective : Upper gastrointestinal (GI) bleeding is a serious complication that sometimes occurs after percutaneous radiologic gastrostomy (PRG). We evaluated the incidence of bleeding complications after a PRG and its management including transcatheter arterial embolization (TAE). Materials and Methods : We retrospectively reviewed 574 patients who underwent PRG in our institution between 2000 and 2010. Eight patients (1.4%) had symptoms or signs of upper GI bleeding after PRG. Results : The initial presentation was hematemesis (n = 3), melena (n = 2), hematochezia (n = 2) and bloody drainage through the gastrostomy tube (n = 1). The time interval between PRG placement and detection of bleeding ranged from immediately after to 3 days later (mean: 28 hours). The mean decrease in hemoglobin concentration was 3.69 g/dL (range, 0.9 to 6.8 g/dL). In three patients, bleeding was controlled by transfusion (n = 2) or compression of the gastrostomy site (n = 1). The remaining five patients underwent an angiography because bleeding could not be controlled by transfusion only. In one patient, the bleeding focus was not evident on angiography or endoscopy, and wedge resection including the tube insertion site was performed for hemostasis. The other four patients underwent prophylactic (n = 1) or therapeutic (n = 3) TAEs. In three patients, successful hemostasis was achieved by TAE, whereas the remaining one patient underwent exploration due to persistent bleeding despite TAE. Conclusion : We observed an incidence of upper GI bleeding complicating the PRG of 1.4%. TAE following conservative management appears to be safe and effective for hemostasis.
Files in This Item:
T201206442.pdf Download
DOI
10.3348/kjr.2012.13.2.174
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Seo, Nieun(서니은) ORCID logo https://orcid.org/0000-0001-8745-6454
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/158367
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