Abdominal Bleeding Therapy - GI Bleed

Bleeding from the GI tract often shows up as passing blood per rectum but can also be vomited blood. There are various causes for GI bleeding including but not limited to peptic ulcers, diverticulosis, hemorrhoids and abnormal blood vessels within the wall of the intestine. A particularly frustrating problem with GI bleeding is that the bleeding is intermittent. Furthermore, by the time the blood reaches the rectum and is passed, the bleeding site is no longer actively bleeding. In order to treat this bleeding with embolization therapy patients must be bleeding while the study is being performed, otherwise physicians will not know which part of the GI tract to treat.

Prior to angiography, other tests/procedures may be performed such as endoscopy or a bleeding scan. 

Embolization is a way of occluding (closing) one or more blood vessels that are doing more harm than good. Various materials( gelfoam, embospheres, or coils may be used, depending on whether vessel occlusion is to be temporary or permanent, or whether large or small vessels are being treated. The material is passed through a catheter (a small plastic tube) with its tip lying in or near the vessel to be closed.

Conscious sedation is provided just prior to starting the procedure.

You will be lying on the x-ray table. The technologist will prepare the skin over the groin by cleaning it with an antiseptic solution and place sterile drapes and towels over you to create a sterile work space.
Lidocaine® local anesthesia is injected into the skin overlying your groin. A catheter is placed into the artery and contrast dye is injected to allow visualization of the arteries that supply the intestine/stomach.  The Interventional radiologist may ask you to hold your breath for a few seconds while the X-rays are taken. If active bleeding is found, the Interventional Radiologist will inject small inert particles to the area until the bleeding has stopped. These particles are mixed with x-ray dye so that the radiologist can be assured that they are going only to the area of interest and not elsewhere.

The catheter is removed and pressure is applied to the groin until there is no bleeding (approximately 15min.)

This procedure typically requires approximately 1.5 - 3 hours.

What happens after the procedure?
Your nurses will continue to monitor your closely.  You most likely will return to the room you were in prior to the angiogram.  You will be required to keep you head flat for 4-6 hours. The nurses will continue to monitor your vital signs. If no bleeding is identified, which is often the case, patients may return for repeated angiograms until a source is identified.

Going home after the procedure:
Since the artery is a high pressure system, patients should refrain from lifting more than 10 lbs, refrain from strenuous activity or anything which causes abdominal distension for the following 48-72 hours. Any straining such as vomiting, coughing, forced bowel movements could dislodge the clot that forms to seal the artery and cause bleeding.Do not take a tub bath, go in a hot tub or submerge in water for 5 days. Leave the sterile dressing on for 24 hours, then shower and clean the area daily.  Place a clean Band-Aid over the site each day for 5 days. Report any signs of infection (redness, swelling, discharge and fever) to your doctor. At home, you can eat normally, but you should continue drinking extra fluids for 1 to 2 days after your procedure.  

If you have any questions or need to reschedule an appointment please feel free to contact the Interventional Radiology Office at 802- 847-8359. Our business hours are Monday – Friday 8:30 a.m. to 5 p.m. Someone is available to take your call after hours for emergencies.

This information is provided by the Fletcher Allen, Department of Radiology, Division of Interventional Radiology and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact your health care provider.