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Prospective study comparing multi-detector row CT and endoscopy in acute gastrointestinal bleeding.
Fabrizio M Frattaroli1, Emanuele Casciani, Domenico Spoletini
1Department of Surgery "P.Stefanini", "Policlinico Umberto I" Hospital, "Sapienza" University of Rome, Viale del Policlinico, 155 00161, Rome, Italy. fabrizio.frattaroli@uniroma1.it
World Journal of Surgery
|August 5, 2009
Summary
Multi-detector row CT scans offer superior accuracy in diagnosing acute gastrointestinal bleeding (AGIB) compared to endoscopy. This study proposes a new diagnostic algorithm for AGIB utilizing CT imaging.
Area of Science:
- Radiology
- Gastroenterology
- Medical Imaging
Background:
- Acute gastrointestinal bleeding (AGIB) presents significant mortality and morbidity risks.
- Advanced computerized tomography (CT) imaging is crucial for managing AGIB.
Purpose of the Study:
- To evaluate the diagnostic accuracy of multi-detector row CT (MDCT) compared to endoscopy for identifying the site and cause of severe AGIB.
- To propose a novel diagnostic algorithm for AGIB based on MDCT findings.
Main Methods:
- Twenty-nine hemodynamically stable patients with severe AGIB underwent both endoscopy and MDCT.
- Diagnostic accuracy was assessed by comparing findings with angiographic, surgical, or post-mortem confirmations.
Main Results:
- MDCT demonstrated 100% sensitivity for site identification and 90.9% for etiology in upper AGIB, outperforming endoscopy (72.7% and 54.5%).
- For lower AGIB, MDCT showed 100% sensitivity for site and 88.2% for etiology, surpassing endoscopy (52.9% and 52.9%).
Conclusions:
- MDCT offers significant advantages over endoscopy in diagnosing AGIB.
- A new diagnostic algorithm incorporating MDCT is proposed for improved AGIB management.
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