Gastrointestinal hemorrhage in hepatocellular carcinoma: management with transhepatic arterioembolization

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.