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

Jungyoup Lee; Kyuseok Kim; You Hwan Jo; Jae Hyuk Lee; Joonghee Kim; Heajin Chung; Ji Eun Hwang

doi:10.15441/ceem.15.006

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

Clin Exp Emerg Med. 2016 Mar 31;3(1):55-58. doi: 10.15441/ceem.15.006. eCollection 2016 Mar.

Authors

Jungyoup Lee¹, Kyuseok Kim¹, You Hwan Jo¹, Jae Hyuk Lee¹, Joonghee Kim¹, Heajin Chung¹, Ji Eun Hwang¹

Affiliation

¹ Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

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.

Keywords: Aorta; Hemorrhage; Intestines; Resuscitation; Shock.