Colonic bleeding embolization - DBaril

Colonic bleeding embolization - DBaril - Angiographic...

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Angiographic embolization for the treatment of lower gastrointestinal bleeding Donald Baril Team IV Conference July 9, 2004
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Case report - W.H. 76 yo M with past medical history of BPH and melanoma and known diverticulosis Transferred from an outside hospital with lower gastrointestinal bleeding Transfused 5U PRBC at outside hospital (Hct 26 35) Outside hospital colonoscopy - diverticulosis with no active bleeding; EGD - no pathology
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Case report - W.H. Transferred to SICU Hemodynamically stable Continued to have hematochezia with dropping hematocrit (35 22) and was transfused an additional 9U PRBC over the following 3 days Bleeding scan localized source to the cecum and ascending colon Proceeded to angiography and embolization
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SMA angiogram
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Selective SMA and ileocolic angiogram
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Selective ileocolic angiogram with coil deployment
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Post-embolization angiogram
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Case report - W.H. Tolerated regular diet Hematocrit remained stable Discharged home on post-procedure day # 3
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Lower gastrointestinal bleeding Annual incidence of 25 per 100,000 patients Gastrointestinal bleeding accounts for 2% of all hospital admissions Lower gastrointestinal bleeds account for approximately ¼ of all patients admitted with gastrointestinal bleeding Incidence of bleeding increases with age Bleeding spontaneously ceases in 80% of cases Mortality rates of 10-15%
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Etiology of lower gastrointestinal bleeding Adolescents and children Inflammatory bowel disease, polyps, Meckel’s diverticulum Adults < 60 Diverticular disease, neoplasms, inflammatory bowel disease Adults > 60 Diverticular disease, angiodysplasia, neoplasms
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This note was uploaded on 01/06/2012 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Colonic bleeding embolization - DBaril - Angiographic...

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