PWE-068 Angiographic embolisation for non-variceal upper gastrointestinal haemorrhage after failed endoscopic therapy—a 5-year district general hospital experience

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Introduction The recent nationwide upper gastrointestinal bleeding audit found that interventional radiology for bleeders are minimally utilised. In our hospital, we have had this service during normal working hours since 2007. This study reviews our experience. Methods We retrospectively reviewed the case notes of all patients who had mesenteric angiogram in our hospital for treatment of gastrointestinal bleeding since 2007. All data were analysed using SPSS V.17 statistical software. Results We identified 32 patients. Three case notes were not available hence, 29 patients were included in this study (19 Male, 10 Female). Mean age group 75 years (Range 40–89). Mean Rockall score was 7 and mean Blatchford score was 12. 15 patients (52%) went straight for radiological embolisation after one attempt at therapeutic endoscopy. Eight patients (22%) were ITU admissions. Final Diagnosis was duodenal ulcer in 22 (76%), gastric ulcer in 6 (21%) and Duodenal Cancer in 1 (3%). Extravasation of contrast at angiogram was seen in only 7% of cases. Gastroduodenal artery was embolised in 25 (87%), left gastric artery in 3 (10%) and Rt gastro-epiploic artery in 1 (3%). No immediate complications were noted as a result of the procedure. Rebleeding was noted in 8 pts (27%). 24 patients (83%) survived more than 30 days. Four (14%) died within 7 days of the procedure and 1 (3%) died after 7 days. 40% (2 out of 5) died of a cause unrelated to rebleed. Conclusion Our study demonstrates success at embolisation and mortality rates similar to the published results of the UK nationwide GI bleeding audit. We believe access to interventional radiology is an important therapeutic strategy that should be available in all hospitals admitting GI bleeders. Competing interests None declared.

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