Sorcha M McNally MBBCh, Presenter: Nothing to Disclose

Jeffrey William McCann, Abstract Co-Author: Nothing to Disclose

Cormac Thomas Farrelly MD, Abstract Co-Author: Nothing to Disclose

Ronan Andrew McDermott MBBCh, Abstract Co-Author: Nothing to Disclose

Niall John McEniff MB, Abstract Co-Author: Nothing to Disclose

Mark Fitzgerald Ryan MD, Abstract Co-Author: Nothing to Disclose

Provocative mesenteric angiography with fibrinolytic therapy has been shown to be useful in the investigation of patients with acute gastrointestinal (GI) bleeding of undiagnosed origin. We aim to review the indications, interventional technique, and potential complications of provocation angiography.

 Clinical symptoms and signs of acute GI bleeding  Causes of acute GI bleeding  Anatomy of the celiac, superior and inferior mesenteric arteries  Standard investigation of acute GI bleeding including endoscopy, tagged red blood cell scintigraphy, and visceral angiography  Indications for provocation angiography  Interventional technique  Incidence of induced bleeding  Treatment options if bleeding occurs  Follow up management  Outcome, including complications

The usefulness and challenges of provocation angiography are presented. The exhibit will review: a. The technique - intra arterial administration of heparin, tissue plasminogen activator (tPA), and papaverine or nitroglycerine followed by multiple selective and superselective angiograms of the entire vascular territory of the superior and inferior mesenteric arteries b. The treatment options if bleeding occurs, including embolization c. Potential risks and complications

McNally, S, McCann, J, Farrelly, C, McDermott, R, McEniff, N, Ryan, M, Provocative Mesenteric Angiography in the Setting of Acute Gastrointestinal Bleeding.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4439060.html