Management of acute arterial gastro-intestinal haemorrhage (2021 – CME) – online course
Authors: R. Patel and R. Uberoi
Reviewers: A. Basile, R. Lakshmi, G. Makris, C. Nice and B. Peynircioglu
This course corresponds to chapter 184.108.40.206.8 Visceral Arterial Disease in the European Curriculum and Syllabus for IR.
Acute gastrointestinal (GI) bleeding is a serious and often life-threatening condition. It is vital to differentiate upper GI (U-GI) and lower GI (L-GI) bleeding where possible, although the clinical presentation and management strategies can often overlap. Patients with GI bleeds must be cared for in appropriate units with multidisciplinary input from the emergency department, gastroenterology, diagnostic and interventional radiology, GI surgery, endoscopy and critical care teams being required. A named team leader is needed to co-ordinate the overall care of the patient. Patients should be appropriately risk stratified and resuscitated. Endoscopy is often the first line of investigation and/or therapy, especially if there is any possibility of the bleed originating from the U-GI tract, and sometimes for L-GI bleeds as well. Multi-slice CT is a rapid, accurate and highly valuable tool in diagnosing GI bleeding as well as planning subsequent endovascular/interventional treatment, such as embolisation, although it should be borne in mind that active GI bleeding is usually intermittent. Nuclear medicine or capsule endoscopic studies are selectively used for slow GI bleeds, which cannot be diagnosed with certainty by endoscopy or CT. IR techniques have proven to be safe and effective, and have largely replaced surgery as the treatment of choice in cases where endoscopic techniques are not feasible or have failed to control GI bleeding.
Every interventional radiologist who provides services for acute patients need to have the appropriate skills and knowledge to manage patients with GI bleeds. This module, with the learning video and text, provides an overview of the necessary anatomy, pathophysiology, indications, contraindications and techniques for treatment, as well as guidance on post-procedural management and follow-up after intervention.
- Gain an understanding of vascular anatomy relevant to GI embolisation.
- Understand the pathophysiology of GI haemorrhage.
- Understand the indications and contraindications for GI embolisation.
- Understand the role of medical, endoscopic, surgical and endovascular treatment options for GI bleeding.
- Understand the role of radiological imaging modalities and endoscopy prior to endovascular treatment of GI haemorrhage.
- Understand the role of empiric embolisation in the management of GI haemorrhage.
- Understand the role of anti-spasmodics, vasodilators, anticoagulants and thrombolytic agents in the evaluation, imaging and management of GI haemorrhage.
- Understand the principles of GI embolisation, likely outcomes and potential complications.
This course covers a basic level of IR knowledge and is designed for trainees, students or young consultants aiming to acquire essential knowledge or prepare for the EBIR exam. Thereby, it is tailored to the European Curriculum and Syllabus for IR and corresponds to chapter 220.127.116.11.8 Visceral Arterial Disease.
The format of the course is interactive and easy to use, including texts, graphics, videos and a quiz to support your learning. The course duration is around one hour and is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to award 1 European CME credit (ECMEC). The CME accreditation for this course will expire on June 16, 2023. A non-CME accredited version of the course will remain available until the new CME accredited course is published.
Access to the course is granted for an enrolment period of 90 days.
The CME certificate will be available in the myCIRSE area past the enrolment period if the course is completed before June 16, 2023.
Release date: June 2021