Interventional Radiology

If endoscopy is unsuccessful or contraindicated, or if bleeding persists despite medical and endoscopic treatment, interventional radiology could be considered depending on local availability.

CT angiogram can often identify the aetiology of GI bleeding which can provide important information for intervention. Culprit vessels for upper GI bleeding include branches of the coeliac axis, such as the left gastric artery, and the gastroduodenal artery.

Once the source is identified, transcatheter arterial embolisation can be used to occlude the culprit vessel as close as possible to the bleeding site. Embolic agents used include coils, glue, polyvinyl alcohol particles, and Amplatzer vascular plugs. [17]