Gastrointestinal bleeding. Radiological diagnosis

Gastrointestinal haemorrhage is a common clinical problem that often presents the clinician with difficulties in diagnosis. The increasingly important role of endoscopy has resulted in a change of emphasis in the radiological investigation of bleeding: while barium studies are still an important part of the investigative sequence in most patients they no longer occupy the central position in diagnosis they once held, despite considerable improvements in technique. At the same time angiography and interventional radiological techniques are becoming progressively more important in the diagnosis and management of gastrointestinal bleeding. In acute gastrointestinal haemorrhage angiography provides not only one of the most accurate techniques for the localization of bleeding (Boijsen and Reuter, 1967) but also the therapeutic option of embolization. In chronic gastrointestinal bleeding of obscure origin angiography may be the only modality of investigation that can successfully locate a microvascular abnormality. In the assessment of portal hypertension angiographic and interventional techniques may provide both physician and surgeon with information vital to the successful management of the patient.