Ho Jeong and his colleague from Korea presented a case of duodenal obstruction after successful selective transcatheter arterial embolization (TAE) for a duodenal diverticular hemorrhage. Their study will be published on August 14, 2009 in the
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In general, angiography and endoscopy are the most useful modalities for diagnosing and managing gastrointestinal bleeding. However, duodenal diverticular hemorrhage complicated by duodenal obstruction can happen after transcatheter arterial embolization by ischemic damage to the duodenum or fibrotic encasement of the duodenum. Complications of peridiverticular and retroperitoneal fibrosis around the resolving hematoma could happen after successful TAE; therefore, the resolving hematoma should be thoroughly observed. Conservative treatment should be considered before surgery to relieve the duodenal obstruction resulting from duodenal fibrotic encasement after duodenal diverticular hemorrhage. However, if surgery is necessary, gastrointestinal diversion should be done instead of complete resection in cases with severe inflammation or tissue friability.
Source: Eurekalert
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