Elçin AYDIN, Fatih DÜZGÜN, Halil BOZKAYA, İsmail ORAN, Mustafa PARILDAR, Celal ÇINAR

Akut Gastrointestinal Kanamanın Bazı Sebepleri: Tespit, Lokalizasyon ve Konvansiyonel Tedavi Anjiyografi

Akut gastrointestinal (GI) kanama yüksek morbidite ve mortalite oranına sebep olan tıbbi bir acildir (1). Akut GI kanama anatomik işaret yeri olan Treitz ligamanına göre iki kategoriye ayrılmıştır (2). Treitz ligamanına gore üstte yerleşen ve % 8-14 mortalitesi olan akut GI kanamaya üst GI kanaması denir (3,4). Treitz ligamanının altında yerleşirse, % 3.6-18 mortalite oranına sahip ise alt GI kanamadır. Akut GI kanamasını bulmak ve lokalize etmek için kullanılan teşhis yöntemleri; endoskopi, kolonoskopi, radyonükleer görüntüleme, konvansiyonel anjiografi veya kontrastlı multidedektör helikal sıralı bilgisayarlı tomografidir (7). Bu makalede, konvansiyonel anjiografi il saptanan ve tedavi edilebilen GI kanama nedenlerine genel bir bakış sunuyoruz.

Anahtar Kelimeler:

kanama, akut, embolizasyon, kateterler, bt, anjiyoplasti, arterler, aorta

PDF

___

1. Jaeckle T, Stuber G, Hoffmann MHK, Freund W, Schmitz BL, Aschoff AJ. Acute gastrointestinal bleeding: Value of MDCT. Abdom Imaging 2008; 33:285-293.
2. Yoon W, Jeong YY, Kim JK. Acute gastrointestinal bleeding: contrastenhanced MDCT. Abdom Imaging 2006; 31:1-8.
3. Sanders DS, Perry MJ, Jones SGW, et al. Effectiveness of an uppergastrointestinal haemorrhage unit: a prospective analysis of 900 consecutive
cases using the Rockall score as a method of risk standardization. Eur J Gastroenterol Hepatol 2004; 16:487-494
4. Van Leerdam ME, Vreeburg EM, Rauws EAJ, et al. Acute upper GI bleeding: did anything change? Time trend analysis of incidence and
outcome of acute upper GI bleeding between 1993/1994 and 2000. Am J Gastroenterol 2003;98:1494-1499
5. Longstreth GF. Epidemiology and outcome of patients hospitalized with acute lower gastrointestinal hemorrhage: a population-based study. Am J Gastroenterol 1997;92:419-424
6. Anthony T, Penta P, Todd RD, et al. Rebleeding and survival after acute lower gastrointestinal bleeding. Am J Surg 2004;188:485-490
7. Stuber T, Hoffmann MHK, Stuber G, Klass O, Feuerlein S, Aschoff AJ. Pitfalls in detection of acute gastrointestinal bleeding with multi- detector row helical CT. Abdom Imaging 2009;34:476-482
8. Boley SJ, DiBiase A, Brandt LJ, Sammartano RJ. Lower intestinal bleeding in the elderly. Am J Surg 1979; 137:57.
9. Laing CJ, Tobias T, Rosenblum DI, Banker WL, Tseng L, Tamarkin SW. Acute Gastrointestinal Bleeding: Emerging Role of Multidetector
CT Angiography and Review of Current Imaging Techniques. Radiographics 2007;27:1055-1070.
10. Uflacker R. Transcatheter embolization for treatment of acute lower intestinal bleeding. Acta Radiol 1987;28:425.
11. Slavin RE. Segmental arterial mediolysis: course, sequelae, prognosis, and pathologic-radiologic correlation. Cardiovascular Pathology 2009;18:352-360.
12. Chao CP. Seminars in Interventional Radiology. 2009;26:224-32.
13. Baker-LePain JC, Stone DH, Mattis A, Nakamura MC, Fye KH. Clinical Diagnosis of Segmental Arterial Mediolysis: Differentiation from
Vasculitis and Other Mimics. Arthritis Care Res (Hoboken) 2010;62:1655-1660.
14. Habib N, Hassan S, Abdou R, Torbey E, Alkaied H, Maniatis T, Azab B, Chalhoub M, Harris K. Gastroduodenal artery aneurysm, diagnosis,
clinical presentation and management: a concise review. Annals of Surgical Innovation and Research 2013;7:4
15. Iyori K, Horigome M, Yumoto S, Yamadera Y, Saigusa Y, Iida F, et al. Aneurysm of the gastroduodenal artery associated with absence of the celiac axis: report of a case. Surg Today 2004;34:360-362.
16. Shanley CJ, Shah NL, Messina LM. Uncommon splanchnic artery aneurysms: pancreaticoduodenal, gastroduodenal, superior mesenteric, inferior mesenteric, and colic. Ann Vasc Surg 1996;10:506-515.
17. Chong WW, Tan SG, Htoo MM. Endovascular treatment of gastroduodenal artery aneurysm. Asian Cardiovasc Thorac Ann 2008;16:68-72.