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Helical CT in acute lower gastrointestinal bleeding
Olivier Ernst1, Philippe Bulois, Sophie Saint-Drenant
1Department of Radiology, Hopital Huriez, 1 rue Polonovski, 59037 Lille, France. pcih@chru-lille.fr
Insights
Helical CT effectively locates acute lower gastrointestinal bleeding sites. This imaging technique aids physicians in diagnosing the source of bleeding in the small bowel and colon.
Area of Science:
- Radiology
- Gastroenterology
- Medical Imaging
Background:
- Acute lower gastrointestinal bleeding is a common clinical challenge.
- Accurate localization of the bleeding source is crucial for effective management.
Purpose of the Study:
- To evaluate the diagnostic utility of helical computed tomography (CT) in identifying the location of acute lower gastrointestinal bleeding.
Main Methods:
- A three-phase helical CT scan of the abdomen was performed on 24 patients with acute lower gastrointestinal bleeding.
- CT findings such as hyperdensity, contrast enhancement, vascular extravasation, bowel wall thickening, polyps, tumors, or vascular dilation were used to diagnose the bleeding site.
- CT results were correlated with colonoscopy, enteroscopy, or surgical findings.
Main Results:
- Helical CT successfully identified the bleeding site in 19 out of 24 patients.
- The bleeding source was located in the colon for 14 patients and the small bowel for 5 patients.
- CT correctly identified 11 colonic hemorrhages and 4 small bowel hemorrhages, and diagnosed the primary lesion in 10 patients.
Conclusions:
- Helical CT is a valuable tool for diagnosing the location of acute lower gastrointestinal bleeding.
- The technique assists clinicians in pinpointing bleeding sources within the gastrointestinal tract.
- Further investigation may refine CT's role in managing gastrointestinal hemorrhage.
Abstract:
The purpose of this study was to assess the usefulness of helical CT in depicting the location of acute lower gastrointestinal bleeding. A three-phase helical CT of the abdomen was performed in 24 patients referred for acute lower gastrointestinal bleeding. The diagnosis of the bleeding site was established by CT when there was at least one of the following criteria: spontaneous hyperdensity of the peribowel fat; contrast enhancement of the bowel wall; vascular extravasation of the contrast medium; thickening of the bowel wall; polyp or tumor; or vascular dilation. Diverticula alone were not enough to locate the bleeding site. The results of CT were compared with the diagnosis obtained by colonoscopy, enteroscopy, or surgery. A definite diagnosis was made in 19 patients. The bleeding site was located in the small bowel in 5 patients and the colon in 14 patients. The CT correctly located 4 small bowel hemorrhages and 11 colonic hemorrhages. Diagnosis of the primary lesion responsible for the bleeding was made in 10 patients. Our results suggest that helical CT could be a good diagnostic tool in acute lower gastrointestinal bleeding to help the physician to diagnose the bleeding site.
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