Enhanced CT for initial localization of active lower gastrointestinal bleeding

Active lower gastrointestinal (GI) bleeding is a potentially dangerous situation because patients with this condition may fall into shock. Colonoscopy, angiography, and scintigraphy have been used widely to localize the source of bleeding, but time is needed to perform these examinations. The purpose of this study was to illustrate how vividly enhanced computed tomography (CT) may show active lower GI bleeding in a short time.

Five of 10 patients with active lower GI bleeding underwent dynamic enhanced CT. Scans were obtained 0.5 and 5 min after intravenous contrast.

Pooling of contrast medium was found in four of five patients. Among the five patients, three had diverticular disease of the colon, one had a rectal ulcer, and one had a small intestinal ulcer. The localization procedure completed within 15 min in all patients. Extravasations of medium were confirmed by two surgeons.

Enhanced helical CT was useful for the detection of an active lower GI bleeding source. The procedure was brief, less invasive, and less demanding. Enhanced CT may be the first step for diagnosing lower GI tract bleeding.