Efficacy of endoscopic ultrasound-guided hemostatic interventions for resistant nonvariceal bleeding

Ryan Law, Larissa Fujii-Lau, Louis M. Wong Kee Song, Christopher J. Gostout, Patrick S. Kamath, Barham K. Abu Dayyeh, Ferga C. Gleeson, Elizabeth Rajan, Mark D. Topazian, Michael J. Levy

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

A subset of patients with nonvariceal gastrointestinal bleeding fail, or are unsuitable candidates for, endoscopic, radiologic, and surgical interventions. Endoscopic ultrasound (EUS)-guided intervention might be effective in these patients. We performed EUS-guided hemostatic interventions for 17 patients with nonvariceal gastrointestinal bleeding from June 2003 through May 2014 who failed, or were unsuitable candidates for, additional therapies. Indications for treatment included gastrointestinal stromal tumors, colorectal vascular malformations, duodenal masses or polyps, Dieulafoy lesions, duodenal ulcers, rectally invasive prostate cancer, pancreatic pseudoaneurysms, ulcerated esophageal cancer, and ulceration after Roux-en-Y gastric bypass. After the procedure, 88% of patients have had no further bleeding related to the treated lesion, over a median follow-up period of 12 months. EUS-guided hemostatic therapy therefore is feasible and useful for select patients with clinically severe, refractory, or recurrent nonvariceal gastrointestinal bleeding.

Original languageEnglish (US)
Pages (from-to)808-812.e1
JournalClinical Gastroenterology and Hepatology
Volume13
Issue number4
DOIs
StatePublished - Apr 1 2015

Keywords

  • Coil Embolization
  • Cyanoacrylate Injection
  • Interventional Endoscopic Ultrasound
  • Refractory GI Bleeding

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Law, R., Fujii-Lau, L., Wong Kee Song, L. M., Gostout, C. J., Kamath, P. S., Abu Dayyeh, B. K., Gleeson, F. C., Rajan, E., Topazian, M. D., & Levy, M. J. (2015). Efficacy of endoscopic ultrasound-guided hemostatic interventions for resistant nonvariceal bleeding. Clinical Gastroenterology and Hepatology, 13(4), 808-812.e1. https://doi.org/10.1016/j.cgh.2014.09.030