Embolización arterial para controlar hemorragias de las vías digestivas altas en pacientes geriátricos: presentación de un caso en un paciente nonagenario
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sep 21, 2022
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Carlos Marío Cortés-Bahamón
Diana Carolina Gámez-Fragoso
Diego Andrés Chavarro Carvajal
Ronald Camilo Gómez Arteaga
https://orcid.org/0000-0002-1652-5042
https://orcid.org/0000-0002-1652-5042
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Resumen
La hemorragia de las vías digestivas altas es una patología con alta incidencia en los adultos mayores de 65 años, y es una de las complicaciones médicas que más demandan servicios de salud. Dados los cambios en la pirámide demográfica mundial, con un crecimiento sin precedentes de la población de adultos mayores, hace que sea un entidad de mucho interés en la práctica médica para los servicios de geriatría, gastroenterología y radiología intervencionista, ya que su incidencia aumenta con la edad. El artículo analiza el caso de un paciente nonagenario, quien presentó sangrado gastrointestinal alto sin adecuado control endoscópico con escleroterapia y clips, quien requirió manejo endovascular y tuvo un adecuado desenlace.
Keywords
Sangrado de tubo digestivo, radiología intervencionista, embolización.
References
Referencias
1. Nable JV, Graham AC. Gastrointestinal Bleeding. Emerg Med Clin North Am. 2016 May;34(2):309-25. https://doi.org/10.1016/j.emc.2015.12.001
2. Nelms DW, Pelaez CA. The acute upper gastrointestinal bleed. Surg Clin North Am. 2018 Oct;98(5):1047-57. https://doi.org/10.1016/j.suc.2018.05.004
3. Stolow E, Moreau C, Sayana H, Patel S. Management of non-variceal upper GI bleeding in the geriatric population: an update. Curr Gastroenterol Rep. 2021 Apr 25;23(4):5. https://doi.org/10.1007/s11894-021-00805-6
4. Khamaysi I, Gralnek IM. Acute upper gastrointestinal bleeding (UGIB) – Initial evaluation and management. Best Pract Res Clin Gastroenterol. 2013 Oct;27(5):633-8. https://doi.org/10.1016/j.bpg.2013.09.002
5. Schweizer U, Grund KE, Fundel J, Wichmann D, Königsrainer A. Therapie der nichtvarikösen oberen gastrointestinalen Blutung: endoluminal – endovaskulär – chirurgisch. Der Chir. 2019 Aug 7;90(8).
6. Wong TCL, Wong K-T, Chiu PWY, Teoh AYB, Yu SCH, Au KWL, et al. A comparison of angiographic embolization with surgery after failed endoscopic hemostasis to bleeding peptic ulcers. Gastrointest Endosc. 2011 May;73(5):900-8. https://doi.org/10.1016/j.gie.2010.11.024
7. Yap FY, Omene BO, Patel MN, Yohannan T, Minocha J, Knuttinen MG, et al. Transcatheter embolotherapy for gastrointestinal bleeding: a single center review of safety, efficacy, and clinical outcomes. Dig Dis Sci. 2013;58(7):1976-84.
8. Lambe G, Courtney M, Judge C, Donlon NE, Ravi N, Ryan M. A case report of endovascular management of delayed upper gastrointestinal bleeding after open esophagectomy for a benign esophageal stricture. Int J Surg Case Rep. 2021;85(July):106277. https://doi.org/10.1016/j.ijscr.2021.106277
9. Loffroy R, Rao P, Ota S, De Lin M, Kwak BK, Geschwind JF. Embolization of acute nonvariceal upper gastrointestinal hemorrhage resistant to endoscopic treatment: results and predictors of recurrent bleeding. Cardiovasc Intervent Radiol. 2010;33(6):1088-100. https://doi.org/10.1007/s00270-010-9829-7
10. Mirsadraee S, Tirukonda P, Nicholson A, Everett SM, McPherson SJ. Embolization for non-variceal upper gastrointestinal tract haemorrhage: a systematic review. Clin Radiol. 2011;66(6):500-9. https://doi.org/10.1016/j.crad.2010.11.016
11. Augustin AM, Fluck F, Bley T, Kickuth R, Augustin AM, Würzburg U. Endovascular therapy of gastroinestinal bleeding. Rofo. 2019 Dec;191(12):1073-1082. English, German. https://doi.org/10.1055/a-0891-1116
12. Barkun AN, Martel M, Toubouti Y, Rahme E, Bardou M. Endoscopic hemostasis in peptic ulcer bleeding for patients with high-risk lesions: a series of meta-analyses. Gastrointest Endosc. 2009 Apr;69(4):786-99. https://doi.org/10.1016/j.gie.2008.05.031
13. Patino-Hernandez D, Borda MG, Venegas Sanabria LC, Chavarro-Carvajal D, Cano-Gutiérrez CA. Disfagia sarcopénica. Rev Colomb Gastroenterol. 2017;31(4):418. https://doi.org/10.22516/25007440.117
14. Kaminskis A, Ivanova P, Kratovska A, Ponomarjova S, Ptašņuka M, Demičevs J, et al. Endoscopic hemostasis followed by preventive transarterial embolization in high-risk patients with bleeding peptic ulcer: 5-year experience. World J Emerg Surg. 2019 Dec 10;14(1).
15. Lai H-Y, Wu K-T, Liu Y, Zeng Z-F, Zhang B. Angiography and transcatheter arterial embolization for non-variceal gastrointestinal bleeding. Scand J Gastroenterol. 2020 Aug 2;55(8). https://doi.org/10.1080/00365521.2020.1790650
16. Choi C, Lim H, Kim M-J, Lee BY, Kim S-Y, Soh JS, et al. Relationship between angiography timing and angiographic visualization of extravasation in patients with acute non-variceal gastrointestinal bleeding. BMC Gastroenterol. 2020 Dec 14;20(1):426. https://doi.org/10.1186/s12876-020-01570-y
1. Nable JV, Graham AC. Gastrointestinal Bleeding. Emerg Med Clin North Am. 2016 May;34(2):309-25. https://doi.org/10.1016/j.emc.2015.12.001
2. Nelms DW, Pelaez CA. The acute upper gastrointestinal bleed. Surg Clin North Am. 2018 Oct;98(5):1047-57. https://doi.org/10.1016/j.suc.2018.05.004
3. Stolow E, Moreau C, Sayana H, Patel S. Management of non-variceal upper GI bleeding in the geriatric population: an update. Curr Gastroenterol Rep. 2021 Apr 25;23(4):5. https://doi.org/10.1007/s11894-021-00805-6
4. Khamaysi I, Gralnek IM. Acute upper gastrointestinal bleeding (UGIB) – Initial evaluation and management. Best Pract Res Clin Gastroenterol. 2013 Oct;27(5):633-8. https://doi.org/10.1016/j.bpg.2013.09.002
5. Schweizer U, Grund KE, Fundel J, Wichmann D, Königsrainer A. Therapie der nichtvarikösen oberen gastrointestinalen Blutung: endoluminal – endovaskulär – chirurgisch. Der Chir. 2019 Aug 7;90(8).
6. Wong TCL, Wong K-T, Chiu PWY, Teoh AYB, Yu SCH, Au KWL, et al. A comparison of angiographic embolization with surgery after failed endoscopic hemostasis to bleeding peptic ulcers. Gastrointest Endosc. 2011 May;73(5):900-8. https://doi.org/10.1016/j.gie.2010.11.024
7. Yap FY, Omene BO, Patel MN, Yohannan T, Minocha J, Knuttinen MG, et al. Transcatheter embolotherapy for gastrointestinal bleeding: a single center review of safety, efficacy, and clinical outcomes. Dig Dis Sci. 2013;58(7):1976-84.
8. Lambe G, Courtney M, Judge C, Donlon NE, Ravi N, Ryan M. A case report of endovascular management of delayed upper gastrointestinal bleeding after open esophagectomy for a benign esophageal stricture. Int J Surg Case Rep. 2021;85(July):106277. https://doi.org/10.1016/j.ijscr.2021.106277
9. Loffroy R, Rao P, Ota S, De Lin M, Kwak BK, Geschwind JF. Embolization of acute nonvariceal upper gastrointestinal hemorrhage resistant to endoscopic treatment: results and predictors of recurrent bleeding. Cardiovasc Intervent Radiol. 2010;33(6):1088-100. https://doi.org/10.1007/s00270-010-9829-7
10. Mirsadraee S, Tirukonda P, Nicholson A, Everett SM, McPherson SJ. Embolization for non-variceal upper gastrointestinal tract haemorrhage: a systematic review. Clin Radiol. 2011;66(6):500-9. https://doi.org/10.1016/j.crad.2010.11.016
11. Augustin AM, Fluck F, Bley T, Kickuth R, Augustin AM, Würzburg U. Endovascular therapy of gastroinestinal bleeding. Rofo. 2019 Dec;191(12):1073-1082. English, German. https://doi.org/10.1055/a-0891-1116
12. Barkun AN, Martel M, Toubouti Y, Rahme E, Bardou M. Endoscopic hemostasis in peptic ulcer bleeding for patients with high-risk lesions: a series of meta-analyses. Gastrointest Endosc. 2009 Apr;69(4):786-99. https://doi.org/10.1016/j.gie.2008.05.031
13. Patino-Hernandez D, Borda MG, Venegas Sanabria LC, Chavarro-Carvajal D, Cano-Gutiérrez CA. Disfagia sarcopénica. Rev Colomb Gastroenterol. 2017;31(4):418. https://doi.org/10.22516/25007440.117
14. Kaminskis A, Ivanova P, Kratovska A, Ponomarjova S, Ptašņuka M, Demičevs J, et al. Endoscopic hemostasis followed by preventive transarterial embolization in high-risk patients with bleeding peptic ulcer: 5-year experience. World J Emerg Surg. 2019 Dec 10;14(1).
15. Lai H-Y, Wu K-T, Liu Y, Zeng Z-F, Zhang B. Angiography and transcatheter arterial embolization for non-variceal gastrointestinal bleeding. Scand J Gastroenterol. 2020 Aug 2;55(8). https://doi.org/10.1080/00365521.2020.1790650
16. Choi C, Lim H, Kim M-J, Lee BY, Kim S-Y, Soh JS, et al. Relationship between angiography timing and angiographic visualization of extravasation in patients with acute non-variceal gastrointestinal bleeding. BMC Gastroenterol. 2020 Dec 14;20(1):426. https://doi.org/10.1186/s12876-020-01570-y
Cómo citar
Cortés-Bahamón, C. M., Gámez-Fragoso, D. C., Chavarro Carvajal, D. A., & Gómez Arteaga, R. C. (2022). Embolización arterial para controlar hemorragias de las vías digestivas altas en pacientes geriátricos: presentación de un caso en un paciente nonagenario . Universitas Medica, 63(3). https://doi.org/10.11144/Javeriana.umed63-3.each
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