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What Are MIIPs? / Gastrointestinal Bleeding
What is Gastrointestinal Bleeding (GI Bleed)?
A GI bleed is bleeding from your digestive tract. The digestive tract extends from the mouth, where food enters the body, to the anus, where stool exits the body. Bleeding can come from any parts of the digestive tract, including the tube connecting the mouth to the stomach (esophagus), stomach, and intestines.
- Bright red blood in vomit
- Vomit that looks like coffee grounds
- Black or tarry stools
- Stool mixed or coated with bright red blood
- Stomach ulcers (also known as peptic ulcers)
- Inflammatory bowel disease (IBD)
- Diverticulosis (outpouchings in the intestines)
- Hemorrhoids (dilated veins around the rectum and anus)
- Colon polyps
- Abnormal blood vessels in the digestive tract
- Cancer
- Infection
GI bleeding can often be diagnosed with medical imaging exams. It can also be diagnosed by a digestive tract specialist called a Gastroenterologist, using a small camera inside the body. The camera can be placed through the mouth into the stomach (called an endoscopy) or into the intestines from the rectum (called a colonoscopy or sigmoidoscopy). The Gastroenterologist can try to close off the bleeding blood vessel with tiny metal clips, bands or injections of special medications. When this doesn’t work, an Interventional Radiologist (IR) can use a minimally invasive, image-guided procedure (MIIP) to find and stop the bleeding by plugging the bleeding vessel from the inside. This MIIP is called embolization.
During embolization, the IR numbs the skin then inserts a thin plastic tube into a blood vessel of the upper thigh or arm. The IR uses moving x-rays to help guide the tube through the blood vessels to the area of concern. The IR then injects contrast dye while taking low dose x-rays in order to see where the bleeding is coming from. Bleeding will look like contrast dye spilling out of the blood vessel or an abnormal tangle of blood vessels. The IR can plug the bleeding blood vessel by injecting special materials through the tiny tube. The blood vessel can be blocked temporarily with a slurry called gelfoam or permanently with small plastic particles, fine metal coils, special plugs or medical grade superglue. The material used for embolization depends on which vessel is bleeding.
After the procedure, the tube is removed and a bandage placed over the small nick in the skin. There is no need for stitches.
Uncommon risks of embolization include
- Damage to the blood vessels
- Bruising or bleeding at the puncture site
- Damage to nearby organs or tissues if the material used to plug up the blood vessel blocks blood flow to these areas
- Damage to the kidneys or allergic reaction from the contrast dye
- Infection
Your doctor will discuss all of the risks and benefits with you before the procedure.
For more information on GI bleeding:
http://www.radiologyinfo.org/en/info.cfm?pg=cathembol
http://www.gastro.theclinics.com/article/S0889-8553(05)70124-2/abstract
http://www.radiologyinfo.org/en/pdf/cathembol.pdf