Revascularization of chronic occluded celiac artery for gastroduodenal coil embolization in massive upper gastrointestinal bleed

TL;DR

A patient with severe stomach bleeding was successfully treated by reopening a blocked artery before embolizing the bleeding vessel.

Contribution

This case highlights a novel approach to managing upper gastrointestinal bleeding in the presence of celiac artery occlusion.

Findings

Recanalization of the celiac trunk enabled safe embolization of the gastroduodenal artery.

Anatomical variations and occlusions must be considered to avoid complications like hepatic ischemia.

Abstract

Upper gastrointestinal bleeding is a serious condition often linked to peptic ulcer disease, contributing to significant morbidity and mortality. A 78-year-old male presented with upper gastrointestinal bleeding that required blood product transfusions despite multiple endoscopic interventions. Although embolization or surgical ligation of the gastroduodenal artery was considered, angiography revealed celiac trunk occlusion, which would increase the risk of hepatic ischemia. Recanalization and stenting of the celiac trunk was performed, facilitating successful embolization of the gastroduodenal artery. This case illustrates the importance of considering anatomical variations and patient risk factors for visceral arterial occlusions, reducing morbidity and mortality.

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