Hegde Siddhi, Sutphin Patrick D, Zurkiya Omar, Kalva Sanjeeva P
Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
CVIR Endovasc. 2023 Aug 17;6(1):42. doi: 10.1186/s42155-023-00386-7.
Occult gastrointestinal bleeding (GIB) is a challenge for physicians to diagnose and treat. A systematic literature search of the PubMed and Embase databases was conducted up to January 1, 2023. Eligible studies included primary research studies with patients undergoing provocative mesenteric angiography (PMA) for diagnosis or localization of occult GIB. Twenty-seven articles (230 patients) were included in the review. Most patients (64.8%) presented with lower GIB. The average positivity rate for provocative angiography was 48.7% (58% with heparin and 46.7% in thrombolytics). Embolization was performed in 46.4% of patients, and surgical management was performed in 37.5%. Complications were rare. PMA can be an important diagnostic and treatment tool but studies with high-level evidence and standardized protocols are needed to establish its safety and optimal use.
隐匿性胃肠道出血（GIB）的诊断和治疗对医生来说是一项挑战。截至2023年1月1日，我们对PubMed和Embase数据库进行了系统的文献检索。符合条件的研究包括对因隐匿性GIB的诊断或定位而接受激发性肠系膜血管造影（PMA）的患者进行的原发性研究。本综述纳入了27篇文章（230例患者）。大多数患者（64.8%）表现为下消化道出血。激发性血管造影的平均阳性率为48.7%（肝素组为58%，溶栓剂组为46.7%）。46.4%的患者接受了栓塞治疗，37.5%的患者接受了手术治疗。并发症很少见。PMA可以是一种重要的诊断和治疗工具，但需要有高级别证据和标准化方案的研究来确定其安全性和最佳使用方法。
