Related Experiment Video
Updated: Mar 13, 2026
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Diagnostic accuracy and implementation of computed tomography angiography for gastrointestinal hemorrhage according
Yoo Jin Choi1, Kyung Su Kim1, Gil Joon Suh1
1Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea.
Insights
Computed tomography (CT) angiography shows improved diagnostic accuracy for severe gastrointestinal hemorrhage (GIH). This imaging technique is more reliable in identifying the source of bleeding in critically ill patients with significant GIH.
Area of Science:
- Radiology
- Gastroenterology
- Emergency Medicine
Background:
- Gastrointestinal hemorrhage (GIH) is a significant clinical challenge.
- Accurate localization of bleeding is crucial for effective management.
- Computed tomography (CT) angiography is a widely used imaging modality for diagnosing GIH.
Purpose of the Study:
- To evaluate the diagnostic accuracy of CT angiography in patients with varying severities of GIH.
- To determine if CT angiography performance differs based on GIH severity.
- To correlate CT angiography findings with clinical outcomes.
Main Methods:
- Retrospective analysis of 262 adult patients with GIH who underwent CT angiography.
- Clinical data including vital signs, lab results, and transfusion volume were collected.
- CT angiography findings were compared against reference standards (endoscopy, surgery, etc.).
- GIH severity was stratified based on packed red blood cell transfusion requirements.
Main Results:
- Patients were classified into mild (28.6%), moderate (53.1%), and severe (18.3%) GIH groups.
- Diagnostic accuracy, particularly the area under the ROC curve, increased with GIH severity (0.780 mild, 0.841 moderate, 0.930 severe).
- CT angiography demonstrated high specificity (94.0%) and positive predictive value (97.3%).
Conclusions:
- CT angiography's diagnostic accuracy for gastrointestinal hemorrhage is significantly better in patients with more severe bleeding.
- The findings suggest CT angiography is a valuable tool for identifying bleeding sources in severe GIH cases.
Objective:
This study compared the diagnostic accuracy of computed tomography (CT) angiography in patients with various severities of gastrointestinal hemorrhage (GIH).
Methods:
We retrospectively enrolled adult patients (n=262) with GIH who had undergone CT angiography from January 2012 to December 2013. Age, sex, comorbidities, presenting symptoms, initial vital signs, laboratory results, transfusion volume, emergency department disposition, and hospital mortality were abstracted from patient records. CT angiography findings were reviewed and compared to reference standards consisting of endoscopy, conventional angiography, bleeding scan, capsule endoscopy, and surgery, either alone or in combination. Clinical severity was stratified according to the number of packed red blood cell units transfused during the first two days: the first quartile was categorized as mild severity, while the second and third quartiles were categorized as moderate severity. The fourth quartile was categorized as severe.
Results:
Patients were categorized into the mild (n=75, 28.6%), moderate (n=139, 53.1%), and severe (n=48, 18.3%) groups. The mean number of transfused packed red blood cell units was 0, 3, and 9.6 in the mild, moderate, and severe groups, respectively. The overall sensitivity, specificity, positive predictive value, and negative predictive value of CT angiography were 73.8%, 94.0%, 97.3%, and 55.3%, respectively. The area under the receiver operating characteristics curve for the diagnostic performance of CT angiography was 0.780, 0.841, and 0.930 in the mild, moderate, and severe groups, respectively, which significantly differed among groups (P=0.006).
Conclusion:
The diagnostic accuracy of CT angiography is better in patients with more severe GIH.
More Related Videos
Related Concept Videos
01:28Imaging Studies for Cardiovascular System V: CT
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:26Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...
01:30Acute Coronary Syndrome III: Diagnostic Studies