Clin Exp Emerg Med.  2016 Mar;3(1):55-58. 10.15441/ceem.15.006.

Use of resuscitative endovascular balloon occlusion of the aorta in a patient with gastrointestinal bleeding

• Lee J
• Kim K
• Jo YH
• Lee JH
• Kim J
• Chung H
• Hwang JE

• KMID: 2360976
• DOI: http://doi.org/10.15441/ceem.15.006

Abstract

Resuscitative endovascular balloon occlusion of the aorta (REBOA) was developed for controlling intra-abdominal arterial bleeding before definitive bleeding control, and is commonly used in patients with ruptured abdominal aortic aneurysms. Although there is limited evidence for other uses of REBOA, we used REBOA in a patient with massive gastrointestinal bleeding. A 53-year-old man with hematochezia was admitted to our emergency department with an initial systolic blood pressure (SBP) of 83 mmHg. His SBP decreased to 40 mmHg in 10 minutes despite rapid fluid infusion. We decided to resuscitate the patient with REBOA in the emergency department and then move him to an intervention room after stabilization. After aortic occlusion, SBP abruptly increased from 57 to 108 mmHg, and the patient could be transferred to an intervention room. The patient was admitted to intensive care, but died of massive rebleeding 24 hours after admission to the emergency department.

Keyword

Resuscitation; Shock; Aorta; Hemorrhage; Intestines

MeSH Terms

Aorta*
Aortic Aneurysm, Abdominal
Balloon Occlusion*
Blood Pressure
Critical Care
Emergency Service, Hospital
Gastrointestinal Hemorrhage
Hemorrhage*
Humans
Intestines
Middle Aged
Resuscitation
Shock