4 Radiological intervention in upper and lower gastrointestinal bleeding

The role of angiography in acute upper GI tract bleeding is less a diagnostic than a therapeutic one because it provides a guide to selective embolization of either the left gastric artery, or the gastroduodenal artery and its two principal branches, the pancreaticoduodenal and the right gastroepiploic artery. Angiographic catheter techniques may also provide substantial diagnostic and therapeutic support for the management of acute lower GI bleeding from a variety of bleeding sources. The advantages are minimal invasion and relatively low risk. The intermittent nature of GI bleeding often interferes with the ability of angiography to demonstrate the source of bleeding. However, at times angiographic techniques provide the only reasonable means of localizing and controlling bleeding.