Westmead Hospital, Sydney, NSW, Australia,
Tech Coloproctol. 2014 Jun;18(6):529-33. doi: 10.1007/s10151-013-1088-6. Epub 2013 Nov 6.
The aim of the present study was to determine the efficacy of mesenteric embolization in the management of acute haemorrhage from the colon.
A retrospective review was performed of a consecutive series of patients who underwent selective arterial embolization between 2002 and 2010 at two Australian institutions. An analysis was performed of each patient's present and past medical history, procedural details and subsequent post-procedural recovery.
Seventy-one patients were reviewed in the study. Sixty-one patients (86 %) had immediate cessation of bleeding following embolization. In total, 20 % had some form of morbidity due to mesenteric embolization being performed, the three most common being worsening renal function, groin haematoma and contrast allergy (11, 9 and 7 %, respectively). Only one patient developed superficial bowel ischaemia. Overall, 11 patients (18 %) had recurrent bleeding. Of these patients, five had repeat embolization. Of the patients who underwent re-embolization, three stopped bleeding. Surgery was required in 5 patients 2 of whom died postoperatively of systemic complications.
Colonic bleeding can be treated successfully in most patients by embolization, without causing ischaemia. Eighteen per cent of patients rebleed during the first hospital admission, and 20 % patients experienced a procedure-related complication. In those patients that proceed to surgery, the morbidity, mortality and length of hospital stay increase dramatically.
本研究旨在确定肠系膜栓塞在治疗结肠急性出血中的疗效。
对 2002 年至 2010 年在澳大利亚的两家机构进行选择性动脉栓塞的连续患者系列进行回顾性分析。对每位患者的现病史、既往病史、手术细节及后续术后恢复情况进行了分析。
本研究共回顾了 71 例患者。61 例（86%）患者栓塞后立即停止出血。总的来说，20%的患者因肠系膜栓塞出现某种形式的并发症，最常见的三种是肾功能恶化、腹股沟血肿和造影剂过敏（分别为 11%、9%和 7%）。只有 1 例患者发生浅表性肠缺血。总体而言，11 例患者（18%）出现再次出血。其中 5 例患者再次进行栓塞治疗。接受再次栓塞治疗的患者中，有 3 例停止出血。5 例患者需要手术，其中 2 例术后死于全身并发症。
栓塞术可以成功治疗大多数患者的结肠出血，而不会导致缺血。18%的患者在首次住院期间再次出血，20%的患者出现与治疗相关的并发症。在需要手术的患者中，发病率、死亡率和住院时间显著增加。
