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Upper Gastrointestinal Tract Hemorrhage

Upper Gastrointestinal Tract Hemorrhage. Zhengyu King. Content. Overview Equipment, Material and method Clinical character Angiography Regional perfusion Local embolism Other Conclusion. Overview. About gastrointestinal tract hemorrhage (GTH)

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Upper Gastrointestinal Tract Hemorrhage

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  1. Upper Gastrointestinal Tract Hemorrhage Zhengyu King

  2. Content • Overview • Equipment, Material and method • Clinical character • Angiography • Regional perfusion • Local embolism • Other • Conclusion

  3. Overview • About gastrointestinal tract hemorrhage (GTH) • Effective method for diagnosis of GTH • Interventional treatment background of the GTH • Clinical application

  4. Equipment & Material • Interventional operation room • Equipment of the angiography • Assistant appliance • Special wire/catheter and relative material • Drug and enbolization material

  5. Methods • Localization of the hemorrhage with selective angiography • Specific method (magnify, induce, bleeding, charge) • Super-selective catheter localization • Regional perfusion or embolization • Others

  6. Others • Equipment of emergency treatment • ECG/BP monitor • oxygen • suction apparatus • Emergency step • transfusion, dilation, blood pressure • Intra/post operation monitor

  7. Clinical character • vital sign(Blood pressure, heart rate) • bleeding status: bleed volume • intestinal tract, intra abdominal cavity • primary etiology • Digestive Ulceration, post-operation ulceration,Disruption of the small artery at anastomotic stoma, instinal tract tumor, vessel malformation, trauma, hemorrhage of diverticulum • conservative therapy

  8. Selective angiography • Method • Indication • Contraindication • Pre-operation preparation • Post-operation precautions

  9. Selective angiography • Super selective angiography • Medication angiography • Significance of angiography for surgery • Artifice of angiography • Limitation of angiography

  10. Interventional therapy:Regional perfusion • Indication • Method • Selection and application of appliance • Selection and application of medicine • Index for the treatment judgement

  11. Interventional therapy:Regional perfusion • Side-affect and complication • Limitation of this method • Precautions • Remediation and timing

  12. Interventional therapy:Local embolization • Indications • Selection of appliance • Embolism material (dosage and selection) • Method of local embolization treatment • Monitor and judgement of the therapy efficacy

  13. Interventional therapy:Local embolization • Contraindications and complications • Special locations • Skill and experience • Application and prospect of some new methods

  14. Interventional therapy: others • Diagnosis of non-arterial gastrointestinal hemorrhage • Trans-cutaneous trans-hepatic portal vein intubatton • TIPSS • Endoscopy interventional treatment

  15. Conclusion Use of selective arterial angiography for diagnosis and treatment of arterial gastrointestinal hemorrhage is a simple, safe and fast emergency method. A specific hemostasis result can be achieved during this procedure, both with less complications. Diagnosis and treatment can be done at the same time.

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