Multidetector computed tomography angiography in non-variceal upper gastrointestinal bleeding: when, why and how?
Alberto Martino1, Marco Di Serafino2, Francesco Manguso1
1Department of Gastroenterology and Digestive Endoscopy, AORN "Antonio Cardarelli", Napoli, Italy.
Expert Review of Gastroenterology & Hepatology
|November 26, 2025
Summary
Multidetector-row computed tomography angiography (MDCTA) shows promise as an adjunct tool for diagnosing non-variceal upper gastrointestinal bleeding (NVUGIB), particularly in severe or rare cases. Further research is needed to establish its role alongside esophagogastroduodenoscopy.
Area of Science:
- Gastroenterology
- Radiology
- Medical Imaging
Background:
- Non-variceal upper gastrointestinal bleeding (NVUGIB) is a frequent emergency with high morbidity and mortality.
- Esophagogastroduodenoscopy (EGD) is the primary diagnostic and treatment method for NVUGIB.
- Multidetector-row computed tomography angiography (MDCTA) has a limited role in NVUGIB diagnosis, though guidelines are evolving.
Purpose of the Study:
- To review current and potential indications for MDCTA in diagnosing NVUGIB.
- To discuss the technical aspects of MDCTA for NVUGIB.
- To evaluate MDCTA's role as an adjunct to EGD.
Main Methods:
- Comprehensive literature search of PubMed, EMBASE, and Google Scholar.
- Review focused on studies published up to May 2025.
- Analysis of MDCTA's diagnostic utility in NVUGIB.
Main Results:
- MDCTA is a promising adjunct diagnostic tool for NVUGIB.
- MDCTA is particularly useful in clinically severe NVUGIB cases.
- MDCTA may aid in diagnosing NVUGIB from rare, non-peptic sources.
Conclusions:
- While EGD is the standard, MDCTA shows potential as a complementary diagnostic modality.
- Evidence supporting MDCTA in NVUGIB is currently limited.
- Further studies are required to fully elucidate MDCTA's role in NVUGIB management.
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