USE ALGORITHM OF ENDOVASCULAR INTERVEN-TIONS IN DIAGNOSIS, TREATMENT AND PREVEN-TION OF NONVARICEAL GASTROINTESTINAL BLEEDINGS

Introduction. Acute gastrointestinal bleedings is a complex problem of modern surgery, requiring multidisciplinary approach. Materials and methods. The experience of using endovascular interventions in 35 patients with nonvariceal gas-trointestinal bleedings for the period of 2009-1018 has been analyzed. 13 patients had bleeding into pancreatic pseudocyst with wirsung duct bleeding or cysto-gastric or cysto-duodenal fistula formation. 11 patients had bleeding gastric ulcer, 5 – gastric tumor, 3 – vascular anomalies. Following angiography, we performed embolization of target vessel. One of the pancreatic pseudocyst patients 14 days after embolization underwent endoscopic pseudocyst drainage, the rest had spontaneous drain-age through the duct or fistula, accompanying with reducing the size or disappearing of the pseudocyst. Recurrence of bleeding appeared in 6 patients (17,1%) within 4 days – 3 months. In 2 of them embolization allowed us to stabilize patient for surgical intervention, 4 – underwent remobilization. 4 patients died within 4-21 days without bleeding recurrence. Results. Endovascular embolization in patients with gastrointestinal bleedings due to ulcer or tumor allows achieving temporary or permanent hemostasis, in patients with bleeding due to pancreatic pseudocyst – to stop bleeding. Conclusion. Using endovascular interventions allows improving the treatment results in patients with gastrointestinal bleedings at the expense of endovascular bleeding stop and/or its recurrence prophylactic.