Unmasking lower gastrointestinal bleeding under administration of norepinephrine  

作　　者：David John Werner Nicolai Wenzel Nael Abusalim Ralf Kiesslich Till Baar Achim Tresch Johannes Wilhelm Rey 

机构地区：[1]Department of Radiology,Helios Dr.Horst-Schmidt-Clinic,Wiesbaden 65199,Hessen,Germany [2]Radiologie Rhein-Nahe,Krankenhaus St.Marienwörth,Bad Kreuznach 55543,Rheinland-Pfalz,Germany [3]Department of Diagnostic and Interventional Radiology,Medical Center Hanau,Hanau 63450,Hessen,Germany [4]Department of Internal Medicine II,Helios Dr.Horst-Schmidt-Clinic,Wiesbaden 65199,Hessen,Germany [5]Institute for Medical Statistics and Computational Biology,Faculty of Medicine,University of Cologne,Cologne 50923,Nordrhein-Westfalen,Germany [6]Department of Gastroenterology and Endoscopy,Medical Center Osnabrueck,Osnabrueck 49076,Niedersachsen,Germany

出　　处：《World Journal of Radiology》2022年第12期375-383,共9页世界放射学杂志（英文版）（电子版）

摘　　要：BACKGROUND Bleeding in the gastrointestinal tract is common and transarterial embolization enables the clinician to control gastrointestinal bleeding.Contrast extravasation is a prerequisite for successful embolization.Provocative angiography is helpful in the detection of elusive bleeding.AIM We performed a retrospective analysis of angiographic treatment in patients with lower gastrointestinal hemorrhage and initially negative angiographies,as well as the role of norepinephrine(NE)in unmasking bleeding.METHODS We analyzed 41 patients with lower gastrointestinal bleeding after angiography who had undergone treatment over a period of 10 years.All patients had a positive shock index and needed intensive care.RESULTS In three of four patients,angiography disclosed the site of bleeding when NE was used during the procedure for hemodynamic stabilization.CONCLUSION We suggest that angiography performed after the administration of NE in unstable patients with gastrointestinal bleeding and an initially negative angiography has the potential to unmask bleeding sites for successful embolization.However,this statement must be confirmed in prospective studies.

关 键 词：Lower gastrointestinal bleeding ENDOSCOPY Provocative angiography NOREPINEPHRINE RADIOLOGY Gastrointestinal bleeding 

分 类 号：R574[医药卫生—消化系统]