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MDCT and CT angiography evaluation of rectal bleeding: the role of volume visualization

Siva P Raman1, Karen M Horton, Elliot K Fishman

  • 1Department of Radiology, Johns Hopkins University, JHOC 3251, 601 N Caroline St, Baltimore, MD 21287, USA. srsraman3@gmail.com

AJR. American Journal of Roentgenology
|August 27, 2013
PubMed

Insights

Multi-detector row CT angiography (MDCT) aids in diagnosing rectal bleeding when colonoscopy is not feasible or inconclusive. This advanced imaging technique offers a valuable alternative for identifying various causes of lower gastrointestinal bleeding, especially in unstable patients.

Area of Science:

  • Radiology
  • Gastroenterology

Background:

  • Rectal bleeding is a common clinical presentation with diverse etiologies.
  • Colonoscopy is the standard diagnostic tool but has limitations, particularly in unstable patients or when findings are negative.

Purpose of the Study:

  • To review the diagnostic utility of multi-detector row CT (MDCT) in evaluating various causes of rectal bleeding.
  • To highlight the role of MDCT, including CT angiography and 3D mapping, as a valuable diagnostic modality.

Main Methods:

  • Review of literature and clinical cases detailing the application of MDCT in diagnosing rectal bleeding.
  • Emphasis on MDCT's capabilities in visualizing anatomical structures and pathological conditions relevant to lower gastrointestinal bleeding.

Main Results:

  • MDCT effectively diagnoses a wide spectrum of rectal bleeding causes, including vascular malformations, varices, ischemic colitis, inflammatory bowel disease, radiation proctopathy, infectious colitis, and rectal cancer.
  • MDCT offers a crucial alternative for patients unsuitable for colonoscopy or those with negative colonoscopy findings.

Conclusions:

  • MDCT with CT angiography is a powerful diagnostic tool for rectal bleeding, serving as a first-line option for hemodynamically unstable patients with active bleeding.
  • It complements colonoscopy by providing diagnostic capabilities when the latter is not possible or fails to identify the bleeding source.
Abstract

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