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Yong-Seol Jeong 1 Article
Massive Duodenal Bleeding after the Migration of Endovascular Coils into the Small Bowel
Chung-Jo Choi, Hyun Lim, Dong-Suk Kim, Yong-Seol Jeong, Sang-Young Park, Jeong-Eun Kim
Clin Endosc 2019;52(6):612-615.   Published online May 20, 2019
AbstractAbstract PDFPubReaderePub
Among gastrointestinal emergencies, acute upper gastrointestinal bleeding remains a challenging clinical problem owing to significant patient morbidity and costs involved in management. Endoscopic hemostatic therapy is the mainstay of treatment and decreases the incidence of re-bleeding, the need for surgery, morbidity, and mortality. However, in 8%–15% of patients with upper gastrointestinal bleeding, endoscopic hemostatic therapy does not successfully control bleeding. Trans-arterial coil embolization is an effective alternative treatment for endoscopic hemostatic failure; however, this procedure can induce adverse outcomes, such as non-target vessel occlusion, vessel dissection and perforation, and coil migration. Coil migration is rare but causes severe complications, such as re-bleeding and bowel ischemia. However, in most cases, coil migration is local and involves spontaneous healing without serious complications. Here, we report the case of a patient who underwent trans-arterial coil embolization of the gastroduodenal artery with the purpose of controlling massive duodenal bleeding, resulting in a fatal outcome caused by coil migration.


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