Study Of Responsible Arteries Of Duodenal Ulcer Hemorrhage And The Significance For Transcatheter Arterial Embolization

Objective: To study the anatomy and findings of DSA of feeding arteries of duodenum,evaluate the significance that judging the responsible arteries of duodenal ulcer hemorrhage accurately for transcatheter arterial embolization.Methods: Reviewed the literature data that related to the anatomy of feeding arteries of duodenum and carried out analysis and induction.There were 17 cases with massive bleeding of duodenal ulcer in this group,all the patients were performed DSA within gastroduodenal arteries or its branches.Analysed the findings of DSA and judged the responsible arteries of duodenal ulcer hemorrhage combining literature data,then performed arterial embolization treatments.Results: The feeding arteries of upper duodenum were ascending duodenal artery(ADA)、pancreaticoduodenal trunk(PDT)、supraduodenal artery(SDA)、retroduodenal artery(RDA)and right gastric artery(RGA),their performances were diverse. The feeding arteries of descending part of duodenum were anterior superior pancreaticoduodenal artery(ASPDA) and posterior superior pancreaticoduodenal artery(PSPDA). The feeding arteries of lower part than descending part of duodenum were posterior inferior pancreaticoduodenal artery(PIPDA) 、anterior inferior pancreaticoduodenal artery(AIPDA) and the branches of first jejunum artery.The responsible arteries of duodenal ampulla ulcer hemorrhage of 14 cases were ADA(8/14)、PDT(3/14)、SDA(3/14)、RDA and ADA common blood supply(1/14),the responsible arteries of descending part of duodenum ulcer hemorrhage of 3 cases were ASPDA and PSPDA. Positive rate of showing signs of bleeding was100%, complete efficiency rate of hemostasis was 88.2%,the success rate of the hemostasia was 100%.Conclusion: The feeding arteries of duodenum were many and their performances were diverse.The responsible arteries ofduodenal ulcer hemorrhage coincided with the anatomy of feeding arteries of duodenum.There was important guiding significance for transcatheter arterial embolization that judgedthe responsible arteries of duodenal ulcer hemorrhage accurately after knowing the anatomy and findings of DSA well offeeding arteries of duodenum.