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KMID : 1038120190520060612
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Clinical Endoscopy
2019 Volume.52 No. 6 p.612 ~ p.615
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Massive Duodenal Bleeding after the Migration of Endovascular Coils into the Small Bowel
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Choi Chung-Jo
Lim Hyun
Kim Dong-Suk
Jeong Yong-Seol
Park Sang-Young
Kim Jeong-Eun
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Abstract
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Among gastrointestinal emergencies, acute upper gastrointestinal bleeding remains a challenging clinical problem owing to significant patient morbidity and costs involved in management. Endoscopic hemostatic therapy is the mainstay of treatment and decreases the incidence of re-bleeding, the need for surgery, morbidity, and mortality. However, in 8%?15% of patients with with upper gastrointestinal bleeding, endoscopic hemostatic therapy does not successfully control bleeding. Trans-arterial coil embolization is an effective alternative treatment for endoscopic hemostatic failure; however, this procedure can induce adverse outcomes, such as non-target vessel occlusion, vessel dissection and perforation, and coil migration. Coil migration is rare but causes severe complications, such as re-bleeding and bowel ischemia. However, in most cases, coil migration is local and involves spontaneous healing without serious complications. Here, we report the case of a patient who underwent trans-arterial coil embolization of the gastroduodenal artery with the purpose of controlling massive duodenal bleeding, resulting in a fatal outcome caused by coil migration.
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KEYWORD
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Coil migration, Endoscopy, Peptic ulcer hemorrhage, Trans-arterial embolization, Upper gastrointestinal bleeding
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