A 58-year-old male patient with lung cancer and multiple metastases was admitted to our ICU. Examination revealed multiple infections including bacteria, fungi, and the novel coronavirus. After aggressive treatment, the patient's condition gradually stabilized and improved. However, he suddenly began to experience massive bleeding of bloody gastric fluid through the gastric tube, exacerbating an already precarious situation.
ICU physicians diagnosed the patient with acute upper gastrointestinal bleeding, recognizing that effective hemostasis was crucial to saving his life. With conventional hemostatic medications proving ineffective, the surgical oncology experts promptly called in the interventional radiology (IR) specialists for urgent consultation, requesting immediate interventional hemostasis for the patient.
However, due to the complexity of the patient's condition and the difficulty in distinguishing arterial from venous bleeding within the mixed gastric fluid, which was vital for determining the approach and success of hemostasis, and considering that the patient could not be disconnected from life support systems such as the ventilator, nor endure excessive interventions, the IR specialists simultaneously suggested inviting experts from the digestive endoscopy center for a joint consultation while coordinating multiple departments to ensure the patient's emergency hemostasis was expedited.
After obtaining informed consent from the patient's family, the experts from the digestive endoscopy center conducted bedside gastroscopy, ruling out the possibility of bleeding from esophageal varices due to liver cirrhosis, and clearly identifying an active bleeding site in the duodenum. The IR specialists swiftly led the interventional team in a race against time, closely coordinating their efforts. Through rapid fluoroscopy, they accurately identified the bleeding location and precisely embolized the responsible blood vessel, successfully stopping the bleeding!
In recent years, interventional medicine has rapidly advanced, revolutionizing traditional treatment concepts. In addition to its well-known role in cancer therapy, interventional treatment also plays a crucial role in managing complications such as bleeding associated with tumors.
For most life-threatening major bleeding events, interventional medicine enables faster identification of the bleeding site and more precise control of bleeding, transforming many previously uncontrollable or difficult-to-treat life-threatening bleeding events into manageable ones. By halting the cascade of deterioration caused by acute massive blood loss and stabilizing circulation, it creates conditions for subsequent treatment, thereby gaining valuable time for patient rescue.
