Value of angiographic embolisation for the control of major haemorrhage after oesophagogastric or pancreaticobiliary surgery

Objective: To assess the effectiveness of selective mesenteric angiography in finding the bleeding point in patients with haemorrhage after upper gastrointestinal operations, and the efficacy of angiographic haemostasis in controlling haemorrhage. Design: Open study. Setting: University teaching hospital in the United Kingdom. Subjects: 6 patients who required urgent investigation for haemorrhage after elective oesophagogastric or pancreaticobiliary operations. Intervention: Mesenteric angiography. Main outcome measures: Identification of bleeding point and control of haemorrhage. Results: Mesenteric angiograms were done at a median of 20 days (range 3–49) after operation and identified the site of bleeding in all 6 patients. Definitive control of bleeding was achieved by embolisation in 2. Further attempts at angiographic embolisation failed to control the bleeding in the other 4. Conclusion: Mesenteric angiography appears to be a valuable investigation in patients with postoperative bleeding after upper gastrointestinal operations. Angiographic embolisation may help to obtain haemostasis, and may stabilise a critically ill patient to allow time for more controlled assessment and treatment. Copyright © 2001 Taylor and Francis Ltd.