Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Eur J Gastroenterol Hepatol. 2013 Jul;25(7):755-63. doi: 10.1097/MEG.0b013e32835fb9a9.
Upper gastrointestinal bleeding (UGIB) remains a frequent presentation in the emergency department. There are several causes of UGIB, which can be generally classified into variceal and nonvariceal bleeding. Although most cases of nonvariceal UGIB spontaneously resolve or respond to medical management and/or endoscopic treatment, transcatheter arterial embolization (TAE) remains an important available tool in the emergency evaluation and management of nonvariceal UGIB. In this article, we will discuss the current strategies for rendering a specific diagnosis of nonvariceal UGIB, and we will focus on the various TAE techniques for its management. We will also provide an algorithm for the diagnostic work-up of these patients. The majority of patients with nonvariceal UGIB that is refractory to endoscopic treatment is successfully treated with minimally invasive TAE and can avoid undergoing surgery.
上消化道出血（UGIB）仍然是急诊科常见的就诊原因。UGIB 有多种病因，通常可分为食管胃静脉曲张出血和非静脉曲张性出血。虽然大多数非静脉曲张性 UGIB 可自发缓解或对药物治疗和/或内镜治疗有反应，但经导管动脉栓塞术（TAE）仍然是在非静脉曲张性 UGIB 的急诊评估和治疗中重要的可用手段。本文将讨论对非静脉曲张性 UGIB 做出明确诊断的当前策略，并重点介绍用于其治疗的各种 TAE 技术。我们还将为这些患者的诊断提供一个算法。大多数对内镜治疗无反应的非静脉曲张性 UGIB 患者可通过微创 TAE 成功治疗，并避免手术。
