Supplementary Material for: Treatment of Gastrointestinal Bleeding in the Biliopancreatic Limb with Embolization in a Patient with Duodenal Switch Anatomy

Introduction: Biliopancreatic diversion with duodenal switch (BPD/DS) is an uncommon type of bariatric surgery that can rarely lead to bleeding in the biliopancreatic limb. The altered anatomy poses significant diagnostic and therapeutic challenges. Case presentation: We present an unusual case of a woman status post BPD/DS nearly a decade ago who presented with gastrointestinal bleeding in the duodenum of the biliopancreatic limb, a rare phenomenon given the unique surgery. Conclusion: We illustrate a promising minimally invasive option of successfully treating the bleeding by interventional radiology (IR) embolization as an alternative to more invasive and challenging options of balloon-assisted enteroscopy, lumen opposing metal stent (LAMS) placement and surgical intraoperative enteroscopy.

引言：胆胰转流术（Biliopancreatic Diversion, BPD/DS）是一种较为罕见的减重外科手术，该手术偶可导致胆胰分支出血。手术后的解剖结构变化给诊断和治疗带来了重大挑战。病例报告：本文介绍了一位女性患者，她在近十年前接受了BPD/DS手术，近期出现胆胰分支十二指肠出血，鉴于手术的独特性，此现象极为罕见。结论：我们展示了通过介入放射学（Interventional Radiology, IR）栓塞治疗出血的微创治疗方案，作为一种替代更为侵入性和具有挑战性的治疗方案，如球囊辅助肠镜检查、腔内金属支架（Lumen Opposing Metal Stent, LAMS）置入和手术中肠镜检查。