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Acute gastrointestinal bleeding: detection of source and etiology with multi-detector-row CT

Hans Scheffel1, Thomas Pfammatter, Stefan Wildi

  • 1Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.

European Radiology
|December 16, 2006
PubMed

Insights

Multi-detector computed tomography (CT) effectively identifies the source and cause of acute gastrointestinal bleeding. This imaging technique accurately characterizes bleeding in most patients, aiding diagnosis and treatment planning.

Area of Science:

  • Radiology
  • Gastroenterology
  • Medical Imaging

Background:

  • Acute gastrointestinal (GI) bleeding is a significant clinical challenge.
  • Accurate identification of bleeding source and etiology is crucial for effective management.

Purpose of the Study:

  • To evaluate the diagnostic capability of multi-detector-row computed tomography (CT) in identifying the source and etiology of acute GI bleeding.
  • To assess the effectiveness of different CT detector rows and contrast phases.

Main Methods:

  • Eighteen patients with acute upper and lower GI bleeding underwent multi-detector-row CT (4, 16, and 64-slice) with arterial and portal venous contrast phases.
  • Unenhanced scans were also performed in a subset of patients.
  • CT scans were reviewed for bleeding source conspicuity, etiology, and potential false-negative findings.

Main Results:

  • CT prospectively identified bleeding sources in 83% of patients, with all sources characterized in retrospect.
  • Contrast extravasation was evident in all severe bleeding cases but only one mild case.
  • Etiology was identified in 83% of patients with contrast-enhanced CT, compared to none with unenhanced scans.
  • Underlying etiology was accurately identified in all patients with mild GI bleeding.

Conclusions:

  • Multi-detector-row CT is a valuable tool for identifying the source of acute GI bleeding.
  • Contrast-enhanced CT, particularly with arterial and portal venous phases, is essential for determining the precise etiology.
  • CT imaging significantly improves the diagnostic accuracy for patients experiencing acute gastrointestinal bleeding.

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