X-RAY ENDOVASCULAR OCCLUSION IN ACUTE ARTERIAL BLEEDINGS FROM UPPER PARTS OF THE GASTROINTESTINAL TRACT IN CHILDREN

Abstract

Acute arterial bleeding from the upper gastrointestinal tract (GIT) is a rare and life-threatening condition in children. The main method of instrumental examination in gastrointestinal hemorrhage (GIH) is fibro-esophagogastroduodenoscopy. If endoscopic diagnostics and hemostasis are ineffective, there are used other diagnostic and surgical methods of the treatment, which are associated with a high incidence of complications and high lethality. Methods of X-ray endovascular surgery, such as embolization of the arteries of the gastrointestinal tract, are life-saving and allow avoid severe traumatic surgical intervention. However, reports about the implementation of these methods in children are rare. We examined and treated 12 children with massive upper arterial GIHs. In 6 children it was managed to stop bleeding with the help of conservative and endoscopic methods of hemostasis. In 6 patients, these methods were ineffective, and they were underwent X-ray endovascular occlusion (XREO) of the blood vessels of the digestive tract. In 5 cases, embolization helped stop the bleeding after the first procedure, one child needed a repeat procedure for another source of the localization. In 6 cases, spirals were used as an embolization material, an autohemulation and microemboli were used in a one child patient. There were no complications associated with X-ray endovascular intervention. XREO is a minimally invasive and highly effective method of stopping the massive upper arterial GIH and can be performed even in children in extremely serious condition.