[Dynamic computed tomography is useful for the diagnosis and colonoscopic treatment of colonic diverticular bleeding]

Area of Science:

• Gastroenterology
• Radiology
• Colorectal Surgery

Background:

• Colonic diverticular bleeding is a common cause of lower gastrointestinal hemorrhage.
• Accurate localization of the bleeding source is crucial for effective endoscopic treatment.
• Traditional diagnostic methods may delay timely colonoscopic intervention.

Purpose of the Study:

• To evaluate the utility of emergency dynamic computed tomography (CT) in identifying bleeding colonic diverticula.
• To assess the impact of CT on the success rate and timing of colonoscopic treatment for diverticular bleeding.

Main Methods:

• A prospective study involving 95 patients diagnosed with colonic diverticular bleeding.
• Patients were divided into two groups: 60 underwent CT before colonoscopy (CT group), and 35 underwent colonoscopy alone (CS group).
• CT scans were analyzed for evidence of active bleeding (extravasation).

Main Results:

• In the CT group, 31 out of 32 patients (96.9%) with detected extravasation on CT had their bleeding diverticula successfully identified and treated by colonoscopy.
• The median interval between bleeding recognition and CT was significantly shorter (1.0 hour) in patients with extravasation detected by CT compared to those without (5.0 hours).
• Colonoscopy alone (CS group) did not have comparable data presented for direct comparison of diagnostic yield or timing.

Conclusions:

• Emergency dynamic CT is a valuable tool for accurately identifying bleeding colonic diverticula.
• Pre-colonoscopy CT significantly improves the localization and facilitates timely endoscopic treatment of active diverticular bleeding.
• The study recommends the use of emergency dynamic CT prior to colonoscopy for patients with suspected colonic diverticular bleeding.