AIM:To evaluate the clinical results of angiography and embolization for massive gastrointestinal hemorrhage after abdominal surgery.METHODS:This retrospective study included 26 patients with postoperative hemorrhage ...AIM:To evaluate the clinical results of angiography and embolization for massive gastrointestinal hemorrhage after abdominal surgery.METHODS:This retrospective study included 26 patients with postoperative hemorrhage after abdominal surgery. All patients underwent emergency transarterial angiography,and 21 patients underwent emergency embolization. We retrospectively analyzed the angiographic features and the clinical outcomes of transcatheter arterial embolization.RESULTS:Angiography showed that a discrete bleeding focus was detected in 21(81%) of 26 patients.Positive angiographic findings included extravasations of contrast medium(n = 9),pseudoaneurysms(n =9),and fusiform aneurysms(n = 3). Transarterial embolization was technically successful in 21(95%) of 22patients. Clinical success was achieved in 18(82%) of 22 patients. No postembolization complications were observed. Three patients died of rebleeding.CONCLUSION:The positive rate of angiographic findings in 26 patients with postoperative gastrointestinal hemorrhage was 81%. Transcatheter arterial embolization seems to be an effective and safe method in the management of postoperative gastrointestinal hemorrhage.展开更多
AIM:To re-examine whether hepatic vein thrombosis(HVT)(classical Budd-Chiari syndrome)and hepatic vena cava-Budd Chiari syndrome(HVC-BCS)are the same disorder.METHODS:A systematic review of observational studies condu...AIM:To re-examine whether hepatic vein thrombosis(HVT)(classical Budd-Chiari syndrome)and hepatic vena cava-Budd Chiari syndrome(HVC-BCS)are the same disorder.METHODS:A systematic review of observational studies conducted in adult subjects with primary BCS,hepatic vein outflow tract obstruction,membranous obstruction of the inferior vena cava(IVC),obliterative hepatocavopathy,or HVT during the period of January2000 until February 2015 was conducted using the following databases:Cochrane Library,CINAHL,MEDLINE,Pub Med and Scopus.RESULTS:Of 1299 articles identified,26 were included in this study.Classical BCS is more common in women with a pure hepatic vein obstruction(49%-74%).HVCBCS is more common in men with the obstruction often located in both the inferior vena cava and hepatic veins(14%-84%).Classical BCS presents with acute abdominal pain,ascites,and hepatomegaly.HVC-BCS presents with chronic abdominal pain and abdominalwall varices.Myeloproliferative neoplasms(MPN)are the most common etiology of classical BCS(16%-62%)with the JAK2V617-F mutation found in 26%-52%.In HVCBCS,MPN are found in 4%-5%,and the JAK2V617-F mutation in 2%-5%.Classical BCS responds well to medical management alone and 1st line management of HVC-BCS involves percutaneous recanalization,with few managed with medical management alone.CONCLUSION:Systematic review of recent data suggests that classical BCS and HVC-BCS may be two clinically different disorders that involve the disruption of hepatic venous outflow.展开更多
Subtle changes have occurred in China, and interventional radiology has gradually become an independent specialty, separated from diagnostic radiology. This has been called "Interventionalogy", "interve...Subtle changes have occurred in China, and interventional radiology has gradually become an independent specialty, separated from diagnostic radiology. This has been called "Interventionalogy", "interventional medicine(IM)", or simply Intervention by our team,and "Interventional Radiology" is used no more. It has even been given the name "Third clinical Medicine" by us. Chinese intervention has established an independent association for interventional doctors, as well as independent interventional societies in many provinces. The national interventional society will likely be set up at some point in time. Chinese interve ntion has set up their own clinical wards, with much attention paid to a clinical, professional, and normalized direction for development, and established special nursing units. According to us, turf battle is meaningless. "The Third clinical Medicine" belongs to all human beings. It could also be predicted that interventional history will follow the same evolutionary rule as other disciplines, i.e., "long divided, must unite; long united, must divide".展开更多
文摘AIM:To evaluate the clinical results of angiography and embolization for massive gastrointestinal hemorrhage after abdominal surgery.METHODS:This retrospective study included 26 patients with postoperative hemorrhage after abdominal surgery. All patients underwent emergency transarterial angiography,and 21 patients underwent emergency embolization. We retrospectively analyzed the angiographic features and the clinical outcomes of transcatheter arterial embolization.RESULTS:Angiography showed that a discrete bleeding focus was detected in 21(81%) of 26 patients.Positive angiographic findings included extravasations of contrast medium(n = 9),pseudoaneurysms(n =9),and fusiform aneurysms(n = 3). Transarterial embolization was technically successful in 21(95%) of 22patients. Clinical success was achieved in 18(82%) of 22 patients. No postembolization complications were observed. Three patients died of rebleeding.CONCLUSION:The positive rate of angiographic findings in 26 patients with postoperative gastrointestinal hemorrhage was 81%. Transcatheter arterial embolization seems to be an effective and safe method in the management of postoperative gastrointestinal hemorrhage.
文摘AIM:To re-examine whether hepatic vein thrombosis(HVT)(classical Budd-Chiari syndrome)and hepatic vena cava-Budd Chiari syndrome(HVC-BCS)are the same disorder.METHODS:A systematic review of observational studies conducted in adult subjects with primary BCS,hepatic vein outflow tract obstruction,membranous obstruction of the inferior vena cava(IVC),obliterative hepatocavopathy,or HVT during the period of January2000 until February 2015 was conducted using the following databases:Cochrane Library,CINAHL,MEDLINE,Pub Med and Scopus.RESULTS:Of 1299 articles identified,26 were included in this study.Classical BCS is more common in women with a pure hepatic vein obstruction(49%-74%).HVCBCS is more common in men with the obstruction often located in both the inferior vena cava and hepatic veins(14%-84%).Classical BCS presents with acute abdominal pain,ascites,and hepatomegaly.HVC-BCS presents with chronic abdominal pain and abdominalwall varices.Myeloproliferative neoplasms(MPN)are the most common etiology of classical BCS(16%-62%)with the JAK2V617-F mutation found in 26%-52%.In HVCBCS,MPN are found in 4%-5%,and the JAK2V617-F mutation in 2%-5%.Classical BCS responds well to medical management alone and 1st line management of HVC-BCS involves percutaneous recanalization,with few managed with medical management alone.CONCLUSION:Systematic review of recent data suggests that classical BCS and HVC-BCS may be two clinically different disorders that involve the disruption of hepatic venous outflow.
文摘Subtle changes have occurred in China, and interventional radiology has gradually become an independent specialty, separated from diagnostic radiology. This has been called "Interventionalogy", "interventional medicine(IM)", or simply Intervention by our team,and "Interventional Radiology" is used no more. It has even been given the name "Third clinical Medicine" by us. Chinese intervention has established an independent association for interventional doctors, as well as independent interventional societies in many provinces. The national interventional society will likely be set up at some point in time. Chinese interve ntion has set up their own clinical wards, with much attention paid to a clinical, professional, and normalized direction for development, and established special nursing units. According to us, turf battle is meaningless. "The Third clinical Medicine" belongs to all human beings. It could also be predicted that interventional history will follow the same evolutionary rule as other disciplines, i.e., "long divided, must unite; long united, must divide".
