Review Note

Last Update: 02/18/2024 05:30 AM

Current Deck: Part 2::6. High Yield Questions::Upper GI

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Currently Published Content


Front
What are the options for local palliation of gastric cancer bleeding? Include in your answer the advantages and disadvantages of each option. (3)
Back
  • Endoscopic management (Gastroenterology)
    • Injection therapy
    • Thermal contact probes 
    • Argon plasma coagulation (non-contact thermal therapy)
      • Advantages: direct visualisation of bleed is possible, immediate effect of achieving arterial or venous bleed
      • Anaesthetics risk. Technically difficult with high volume bleed. Risk of perforation with thermal therapy.
      • Overall rebleeding risk following endoscopic management is high.
  • Palliative RT
    • No anaesthetics required. More lasting haemostasis compared to above.
    • Often takes longer to plan and effect to be seen.
    • More effective for venous bleeds, arterial bleeds are harder to control.
  • Angiographic embolisation (Interventional radiology)
    • Can be performed with light sedation
    • There must be an accessible artery for embolization
    • Not effective for venous bleeds via multiple channels
Further information, not for memorising (no card)
Exam

Current Tags:

#clinonc #palliative #stomach

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