Dn. Srivastava et al., Gastrointestinal hemorrhage in hepatocellular carcinoma: management with transhepatic arterioembolization, ABDOM IMAG, 25(4), 2000, pp. 380-384
Gastrointestinal hemorrhage in patients with hepatocellular carcinoma is co
mmon and a major contributor to mortality. These patients tend to have a ve
ry poor prognosis. This report describes five such cases in which gastroint
estinal bleeding was one of the presenting problems and required urgent man
agement. The causes of massive intermittent gastrointestinal bleeding were
variceal (two cases), direct invasion of the duodenum tone case), transvers
e colon tone case), and stomach tone case). All five patients were inoperab
le because of locally advanced disease, poor general condition, or comorbid
disorders and were managed with angioembolization. After transcatheter emb
olization, the bleeding stopped completely in two patients and was reduced
significantly in the remaining three. We report the role of transhepatic ar
terioembolization in the management of gastrointestinal bleed in such patie
nts, and we recommend its use more often in similar situations.