CT enteroclysis in the diagnosis of obscure gastrointestinal bleeding: initial results

Jain, Tarun; Gulati, Manpreet Singh; Makharia, Govind; Bandhu, Suman; Garg, Pramod Kumar

doi:10.1016/j.crad.2007.01.026

Cited by 31 publications

(19 citation statements)

References 12 publications

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“…In the subset of patients with active overt bleeding, the diagnostic yield for dual‐phase CTE was 80%. While prior studies using CT for the evaluation of obscure gastrointestinal bleeding demonstrated only limited utility of CT, those studies may have lower yield because they did not utilize large volumes of a neutral enteric contrast to distend and visualize the small bowel and were frequently only single‐phase 38–44 …”

Section: Discussionmentioning

confidence: 99%

Diagnostic yield of dual‐phase computed tomography enterography in patients with obscure gastrointestinal bleeding and a non‐diagnostic capsule endoscopy

Agrawal

Travis

Mortelé

et al. 2012

J of Gastro and Hepatol

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Section: Discussionmentioning

confidence: 99%

Diagnostic yield of dual‐phase computed tomography enterography in patients with obscure gastrointestinal bleeding and a non‐diagnostic capsule endoscopy

Agrawal

Travis

Mortelé

et al. 2012

J of Gastro and Hepatol

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“…Compared with capsule endoscopy, multislice CT has a limited overall diagnostic yield but a similar positive rate Previous studies report that the diagnostic yield of MSCT varies from 24.6% to 47.6%, 25,26 while that of CE in OGIB ranges from 38% to 83%. 16,[27][28][29][30] In this study, we reported a relatively high diagnostic yield of 47.56% and 68.66% for MSCT and CE, respectively.…”

Section: Discussionmentioning

confidence: 99%

Obscure gastrointestinal bleeding: diagnostic performance of 64-section multiphase CT enterography and CT angiography compared with capsule endoscopy

He¹,

Gong²,

Hu³

et al. 2014

BJR

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“…Multiple studies have demonstrated that the yields for imaging techniques are higher in the setting of overt bleeding compared with patients with occult bleeding ( 151,(156)(157)(158)(159).…”

Section: Usage Of Abdominal Imagingmentioning

confidence: 99%

ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding

Gerson

Fidler

Cave³

et al. 2015

American Journal of Gastroenterology

584

559

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Bleeding from the small intestine remains a relatively uncommon event, accounting for ~5-10% of all patients presenting with gastrointestinal (GI) bleeding. Given advances in small bowel imaging with video capsule endoscopy (VCE), deep enteroscopy, and radiographic imaging, the cause of bleeding in the small bowel can now be identified in most patients. The term small bowel bleeding is therefore proposed as a replacement for the previous classification of obscure GI bleeding (OGIB). We recommend that the term OGIB should be reserved for patients in whom a source of bleeding cannot be identified anywhere in the GI tract. A source of small bowel bleeding should be considered in patients with GI bleeding after performance of a normal upper and lower endoscopic examination. Second-look examinations using upper endoscopy, push enteroscopy, and/or colonoscopy can be performed if indicated before small bowel evaluation. VCE should be considered a first-line procedure for small bowel investigation. Any method of deep enteroscopy can be used when endoscopic evaluation and therapy are required. VCE should be performed before deep enteroscopy if there is no contraindication. Computed tomographic enterography should be performed in patients with suspected obstruction before VCE or after negative VCE examinations. When there is acute overt hemorrhage in the unstable patient, angiography should be performed emergently. In patients with occult hemorrhage or stable patients with active overt bleeding, multiphasic computed tomography should be performed after VCE or CTE to identify the source of bleeding and to guide further management. If a source of bleeding is identified in the small bowel that is associated with significant ongoing anemia and/or active bleeding, the patient should be managed with endoscopic therapy. Conservative management is recommended for patients without a source found after small bowel investigation, whereas repeat diagnostic investigations are recommended for patients with initial negative small bowel evaluations and ongoing overt or occult bleeding.

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CT enteroclysis in the diagnosis of obscure gastrointestinal bleeding: initial results

Cited by 31 publications

References 12 publications

Diagnostic yield of dual‐phase computed tomography enterography in patients with obscure gastrointestinal bleeding and a non‐diagnostic capsule endoscopy

Diagnostic yield of dual‐phase computed tomography enterography in patients with obscure gastrointestinal bleeding and a non‐diagnostic capsule endoscopy

Obscure gastrointestinal bleeding: diagnostic performance of 64-section multiphase CT enterography and CT angiography compared with capsule endoscopy

ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding

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