Experience in diagnosis and treatment of digestive tract bleeding with gastrointestinal vascular malformation / 临床外科杂志

ABSTRACT

Objective To summarize the experience of diagnosis and management of bleeding with GIVM.Method The clinical data of 26 patients admitted from 1989 to 1999 were analyzed retrospectively.Results GIVM with bleeding were revealed by endoscopies (42%),by ECT (55%),by selective arteriography (83%),by barium radiography (0%),and by exploratory laparotomy(100%).1 case was cured by conservative treatment.Bleeding intestinal segment was resected in 14 cases.4 cases were cured by interventional therapy.The others were cured by sclerosing agent injection,or by suture ligation of the dilated vessel or arterial gastroduodenalis.Conclusions Endoscopy is the first choice in the bleeding from GIVM.ECT may beused later if endoscopy is useless.Selective arteriography is the most valuable method in GIVM diagnosis.If necessary, exploratory laparotomy and intraoperative endoscopies may be used.Resecting bleeding segment is the most effective treatment.Other methods such as interventional therapy and suture ligation of dilated vessel are also effective.