Angiographic and Interventional Radiological Management of Obscure Overt Gastrointestinal Bleeding

Introduction: Gastrointestinal bleeding represents an important clinical problem, which can be encountered in several presentations including overt, occult and obscure forms. The management of gastrointestinal bleeding represents an important clinical problem particularly the obscure overt bleeding. This study aimed to evaluate the role of angiography in the management of this type of bleeding. Patients and Methods: 30 patients (25 males and 5 females) The age ranged from 16-72 years with the mean age 67.9 years, the patients presented with obscure overt gastrointestinal bleeding and were studied at our interventional radiologic unit. Six patients with hematemesis and melena, 15 patients with only melena, 5 patients with melena and hematochesia and 4 patients with hematochesia only. Angiography as digital subtraction technique with embolotherapy was done for all. Results: Angiodiagnosis showed dysplasia in 24 patients, colonic diverticulum in 3 patients, small intestinal tumors in 2 patients and solitary rectal ulcer in one patient. The embolotherapy was successful in 24 patients and failed in 6 patients. Conclusion: Angiography has a definite and indispensible role in the management of obscure overt gastrointestinal bleeding. Diagnostic angiography followed by embolotherapy may represent and alternative non invasive technique that may replace surgery.