SYNCHRONOUS EMBOLIZATION OF THE GASTRODUODENAL ARTERY AND THE INFERIOR PANCREATICODUODENAL ARTERY IN PATIENTS WITH MASSIVE DUODENAL HEMORRHAGE

PURPOSE: To assess the efficacy and safety of synchronous embolization of the gastroduodenal artery (GDA) and inferior pancreaticoduodenal a rtery (IPDA) in patients with massive duodenal hemorrhage, PATIENTS AN D METHODS: All cases of synchronous embolization of the GDA and IPDA a t the authors' hospital between 1980 and 1989 were retrospectively rev iewed, RESULTS: Bleeding was successfully controlled acutely in all si x patients who underwent synchronous embolization. Clinical evidence o f recurrent hemorrhage was found in two patients, but repeat angiograp hy showed no extravasation of contrast material, Three patients died w ithin 30 days of embolotherapy, In one patient who also received an in fusion of vasopressin, postmortem evidence of pancreatic necrosis was found, CONCLUSION: Synchronous embolization of the GDA and IPDA can be an effective treatment for continuing duodenal hemorrhage after faile d endoscopic therapy in patients considered a poor surgical risk, The procedure should be undertaken only as a lifesaving measure due to the risk of pancreatic and duodenal necrosis.