Duodenal ulcer hemorrhage treated by embolization : results in 28 patients

Background : To assess the effectiveness and prospects of tran- scatheter gastroduodenal artery embolization in the control of massive duodenal bleeding and to relate our experience. Methods of study : The study is based on the retrospective analy- sis of 165 patients with endoscopically detected bleeding duodenal ulcer who presented between 1991-1998. 28 patients were consid- ered eligible for endovascular treatment either at initial presenta- tion or following hemorrhage recurrence after endoscopic therapy. Results : Technical failure was noted in 3 cases, thereafter treat- ed by surgery. In the other 25 patients, embolization was per- formed : bleeding recurrence occurred in 7 cases. Four were treat- ed only endoscopically. One was reembolized and the last two were treated by surgery. In 6 cases, a coaxial technique was used (guid- ing catheter in 2 and 3F microcatheter in 4). No complication related to the catheterization was observed. Conclusion : Transcatheter embolization of the gastroduodenal artery appears to be an efficient procedure even in the absence of active bleeding at the time of the procedure. Failure and recur- rence rates can be reduced by using a coaxial technique in the uneasy cases. Embolization seems to have a low recurrence rate and a very low complication rate. (Acta gastroenterol. belg., 2002, 65, 6-11).