الفهرس 
Anatomy
Gross AnatomyOnly 14 pages are availabe for public view
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Abstract
Gastrointestinal bleeding is a common
mostly self-limited disorder with multiple
consequences if not treated properly . Most of
the cases respond to medical and endoscopic
treatment which are consider the main lines of
management. Yet in refractory cases in which
bleeding persist even after traditional
management here come the role of Endovascular
embolization .
The classification of GI bleeding is
performed according to it’s location in relation
to ligament of Treitz into upper and lower GI
bleeding . Etiology of Gastrointestinal bleeding
is highly variable . As regard Upper GI
bleeding, The most common cause of Non
variceal bleeding is a complication of peptic
ulcer disease , yet Mallory- Weiss tear,
gastroduodenal erosions, Arterio-venous
malformations and bleeding secondary tumours
are also frequent causes .Lower GI bleeding is
most commonly due to diverticulosis , also
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vascular ectasia , various form of colitis ,
colonic neoplasia and anorectal causes .
Patients with GI bleeding may come with
different clinical picture such as hematemesis, ,
bleeding per rectum , melena and hematochezia.
Diagnosis depends mainly on upper and lower
endoscopy which is considered diagnostic and
treatment tool at same time .Other important
diagnostic tools are CT angiography (CTA) and
Radionuclide scintigraphy (RS) which can detect
flow rates as low as 0.1 mL/min but not
practical in emergency cases.
Therapeutic endoscopy is usually the first
line of management either the cause of bleeding
is upper or lower GIB .In refractory cases
Endovascular transcatheter embolization and
surgery are used when endoscopy fails to
manage the condition . Both Endovascular
transcatheter embolization and surgery have
nearby equal results , yet endovascular
embolization has the advantage of being
minimally invasive technique with less rate of
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complications in comparison to surgery
especially in debilitated surgical unfit , elderly,
or patients with coagulopathy.
The goal of endovascular transcatheter
embolization is super-selective catheterization of
the bleeding vessels and embolization via
variable embolizing agents in order to
minimize the arterial perfusion pressure while
maintaining adequate collateral blood flow to
decrease the risk of bowel infarction
In conclusion; Advances in Endovascular
catheter-based techniques and newer embolic
materials, as well as recognition of the
effectiveness of minor invasive procedure
options have expanded the role of Transcatheter
Endovascular Super selective Arterial
Embolization in the management of Acute GI
Bleeding with our study showing acceptable
improvement of the laboratory and clinical data
with decrease in the mortality and morbidity rate
among the treated patients, without major
complications.