Table 2.
Definitive diagnosis
|
Case number
|
Bleeding site
|
Diagnostic modality
|
CT angiographic findings
|
Angiographic findings
|
Time from hemorrhage onset to definitive diagnosis (d)
|
Time from hemorrhage onset to EVT (d)
|
| 1 | RGA | CT angiography | Extravasation | Extravasation | 0 | 0 |
| 2 | SA | CT angiography | Extravasation | Extravasation | 0 | 141 |
| 3 | RHA | CT angiography | Enlargement of pseudoaneurysm | Pseudoaneurysm; Extravasation | 1 | 0 |
| 4 | Cholangiojejunostomy | Clinical findings2 | None | None | 0 | 0 |
| 5 | DPA | CT angiography | Extravasation | Extravasation | 0 | 0 |
| 6 | GDA stump | CT angiography | Extravasation | Extravasation | 0 | 0 |
| 7 | RHA | CT angiography | Extravasation | Extravasation | 0 | 0 |
| 8 | GDA stump | CT angiography | Pseudoaneurysm; Extravasation | Pseudoaneurysm | 0 | 0 |
| 9 | DPA | CT angiography | Extravasation | Extravasation; Pseudoaneurysm | 0 | 0 |
| 10 | PHA | CT angiography | Pseudoaneurysm | Obstruction of CHA; Pseudoaneurysm | 0 | 1 |
| 11 | RHA | CT angiography | Pseudoaneurysm | Pseudoaneurysm | 0 | 0 |
| 12 | GDA stump | Laparotomy3 | None (hematoma only) | None (stenosis of CHA) | 0 | 0 |
| 13 | GDA stump | Angiography | Extravasation | Extravasation | 0 | 0 |
| 14 | GDA stump | CT angiography | Extravasation | Extravasation; Pseudoaneurysm | 0 | 0 |
| 15 | GDA stump | CT angiography | Minor extravasation | Extravasation; Pseudoaneurysm | 0 | 1 |
| 16 | GDA stump | CT angiography | Pseudoaneurysm; Extravasation | Pseudoaneurysm; Extravasation | 0 | 0 |
Hematemesis and endoscopic findings.
Two surgical approaches were challenged during 14 d.
Bleeding from the GDA was detected during laparotomy, even though computed tomography angiography and angiographic findings did not revealed extravasation. The endovascular treatment was done under the laparotomy. CHA: Common hepatic artery; CT: Computed tomography; DPA: Dorsal pancreatic artery; EVT: Endovascular treatment; GDA: Gastroduodenal artery; RGA: Right gastric artery; RHA: Right hepatic artery; PHA: Proper hepatic artery; SA: Splenic artery.