Upper Gastrointestinal Tract Hemorrhage
description
Transcript of Upper Gastrointestinal Tract Hemorrhage
Upper Gastrointestinal Upper Gastrointestinal Tract HemorrhageTract Hemorrhage
Zhengyu King
Content
• Overview
• Equipment, Material and method
• Clinical character
• Angiography
• Regional perfusion
• Local embolism
• Other
• Conclusion
Overview
• About gastrointestinal tract hemorrhage (GTH)
• Effective method for diagnosis of GTH
• Interventional treatment background of the GTH
• Clinical application
Equipment & Material
• Interventional operation room
• Equipment of the angiography
• Assistant appliance
• Special wire/catheter and relative material
• Drug and enbolization material
Methods
• Localization of the hemorrhage with selective angiography
• Specific method (magnify, induce, bleeding, charge)
• Super-selective catheter localization
• Regional perfusion or embolization
• Others
Others
• Equipment of emergency treatment
ECG/BP monitor oxygensuction apparatus
• Emergency step
transfusion, dilation, blood pressure
• Intra/post operation monitor
Clinical character
• vital sign(Blood pressure, heart rate)
• bleeding status: bleed volume
• intestinal tract, intra abdominal cavity
• primary etiology
Digestive Ulceration, post-operation ulceration,Disruption of the small artery at anastomotic stoma, instinal tract tumor, vessel malformation, trauma, hemorrhage of diverticulum
• conservative therapy
Selective angiography
• Method
• Indication
• Contraindication
• Pre-operation preparation
• Post-operation precautions
Selective angiography
• Super selective angiography
• Medication angiography
• Significance of angiography for surgery
• Artifice of angiography
• Limitation of angiography
Interventional therapy:Regional perfusion
• Indication
• Method
• Selection and application of appliance
• Selection and application of medicine
• Index for the treatment judgement
Interventional therapy:Regional perfusion
• Side-affect and complication
• Limitation of this method
• Precautions
• Remediation and timing
Interventional therapy:Local embolization
• Indications
• Selection of appliance
• Embolism material (dosage and selection)
• Method of local embolization treatment
• Monitor and judgement of the therapy efficacy
Interventional therapy:Local embolization
• Contraindications and complications
• Special locations
• Skill and experience
• Application and prospect of some new methods
Interventional therapy: others
• Diagnosis of non-arterial gastrointestinal hemorrhage
• Trans-cutaneous trans-hepatic portal vein intubatton
• TIPSS
• Endoscopy interventional treatment
Conclusion
Use of selective arterial angiography for diagnosis and treatment of arterial gastrointestinal hemorrhage is a simple, safe and fast emergency method. A specific hemostasis result can be achieved during this procedure, both with less complications. Diagnosis and treatment can be done at the same time.