Diagnostic accuracy of computerized tomography (CT) angiography in detecting non-variceal gastrointestinal bleeding (NVGIB): a sistematic review

Ciarambino, Tiziana; Giannico, Orazio Valerio; Menna, Giovanni; G, Sansone; Para, Ombretta; Giordano, Mauro; Corrente, Antonio; Adinolfi, Luigi Elio

doi:10.23736/s1121-421x.20.02762-2

Cited by 3 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent systematic review from Ciarambino et al . also showed a high pooled sensitivity of 85% over 11 studies 22 . The discrepancy to this study may, at least in part, stem from a culture of over‐scanning in the Australian healthcare system, which has been documented in other body systems 23 .…”

Section: Discussioncontrasting

confidence: 78%

“…21 A recent systematic review from Ciarambino et al also showed a high pooled sensitivity of 85% over 11 studies. 22 The discrepancy to this study may, at least in part, stem from a culture of over-scanning in the Australian healthcare system, which has been documented in other body systems. 23 Possible reasons for this medical culture include malpractice claims if physicians fail to order diagnostic tests, 24 perceived normative behaviour of what colleagues would do under similar circumstances 24 and also time pressures that are particularly relevant in the emergency department.…”

Section: Discussionmentioning

confidence: 65%

See 1 more Smart Citation

Role of CT angiography and therapeutic anticoagulation in patients presenting to the emergency department with acute gastrointestinal bleeding

et al. 2022

View full text Add to dashboard Cite

Introduction: Acute gastrointestinal bleeding (GIB) is associated with morbidity and mortality. There can be a low threshold for practitioners to assess for active GIB and computed tomography angiography (CTA) examinations are performed frequently, even for stable patients and those who are therapeutically anticoagulated. We aimed to assess the predictive value of CTA for acute GIB and the influence of CTA on treatment. Methods: Retrospective single-centre study over a 2-year period. Results: A total of 227 patients with mean age 67.7 years (SD 17.86), 58.6% male. 84.4% were for lower GIB. 49 patients were on therapeutic anticoagulation (21.6%). 45 CTAs were positive (19.8%). 22 patients received embolisation, and 15 received acute endoscopic treatment. CTA sensitivity was 68.6% and specificity 89.1%. The PPV was 53.3% and NPV 93.9%. The odds ratio of a positive CTA requiring treatment for patients on therapeutic anticoagulation was 1.1 (P = 0.932) compared with the odds of patients not taking therapeutic anticoagulation 21.5 (P < 0.001). The risk ratio for requiring treatment if not taking anticoagulation was 6.2.A total of 19 patients (9.1%) met the definition of CI-AKI as a result of the CTA. A pre-existing eGFR of less than 20 was associated with significantly increased odds of developing CI-AKI (OR 3.95, P = 0.031, 95%CI 1. 135-13.782). Conclusions: The presence of anticoagulation has a significant impact on the decision not to perform interventional treatments on patients with acute GIB when CTA is positive. Anticoagulant reversal and volume resuscitation are important front-line measures, and CTA may have a role for those anticoagulated who are haemodynamically unstable after resuscitation.

show abstract

Section: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 65%

Role of CT angiography and therapeutic anticoagulation in patients presenting to the emergency department with acute gastrointestinal bleeding

et al. 2022

View full text Add to dashboard Cite

show abstract

“…3 , d), eventually leading to re-bleeding. Moreover, CTA is useful for evaluating postoperative anatomical changes and bleeding vessels [ 11 ]. In summary, endoscopic titanium clips, intraoperative aortography, and preoperative contrast-enhanced CT or CTA can be performed to identify the responsible bleeding vessel to a certain extent [ 12 – 14 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of transcatheter arterial embolization in treating nonvariceal gastric remnant bleeding: a retrospective 5-year study

Wu,

Peng,

Zhou

et al. 2024

BMC Gastroenterol

View full text Add to dashboard Cite

Background Gastric remnant bleeding is a special case of upper gastrointestinal bleeding with certain specific disease characteristics, and some matters of transcatheter arterial embolization (TAE) for hemostasis need attention. In this study, we aimed to explore the clinical use of TAE in patients with nonvariceal gastric remnant bleeding and identify the factors influencing the clinical efficacy of these interventions. Methods Data were retrospectively analyzed from 42 patients for whom angiography and embolization were performed but could not be treated endoscopically or had failed endoscopic management in our department between January 2018 and January 2023 due to nonvariceal gastric remnant bleeding. We investigated the relationship between the incidence of re-bleeding and the following variables: sex, age, pre-embolization gastroscopy/contrast-enhanced computer tomography, embolization method, aortography performance, use of endoscopic titanium clips, and the presence of collateral gastric-supplying arteries. Results Forty-two patients underwent 47 interventional embolizations. Of these, 16 were positive for angiographic findings, and 26 were negative. Based on arteriography results, different embolic agents were selected, and the technical success rate was 100%. The incidence of postoperative re-bleeding was 19.1% (9/47), and the overall clinical success rate was 81.0% (34/42). Logistic regression analysis of the relationship between the incidence of early re-bleeding following embolization and the proportion of collateral gastric supply arteries revealed an odds ratio of 10.000 (p = 0.014). Conclusions Utilizing TAE for nonvariceal gastric remnant bleeding is safe and effective. The omission of collateral gastric-supplying arteries can lead to early re-bleeding following an intervention.

show abstract

The Accuracy of Computed Tomography Angiography Compared With Technetium-99m Labelled Red Blood Cell Scintigraphy for the Diagnosis and Localization of Acute Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis

Yaxley

Mulhem

Godfrey

et al. 2023

Current Problems in Diagnostic Radiology

View full text Add to dashboard Cite

Diagnostic accuracy of computerized tomography (CT) angiography in detecting non-variceal gastrointestinal bleeding (NVGIB): a sistematic review

Cited by 3 publications

References 0 publications

Role of CT angiography and therapeutic anticoagulation in patients presenting to the emergency department with acute gastrointestinal bleeding

Role of CT angiography and therapeutic anticoagulation in patients presenting to the emergency department with acute gastrointestinal bleeding

Efficacy of transcatheter arterial embolization in treating nonvariceal gastric remnant bleeding: a retrospective 5-year study

The Accuracy of Computed Tomography Angiography Compared With Technetium-99m Labelled Red Blood Cell Scintigraphy for the Diagnosis and Localization of Acute Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About