Helical CT angiography in gastrointestinal bleeding of obscure origin.

Ettorre, G C; Francioso, G; Garribba, A. P.; Fracella, Maria Rosaria; Greco, A; Farchi, G

doi:10.2214/ajr.168.3.9057524

Cited by 125 publications

(59 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A study first published by Ettore et al in 1997 found that helical CT angiography revealed the site of hemorrhage in 72 % (13/18) of patients and the diagnosis of bleeding site was confirmed at surgery in 11 of these 13 patients. Despite the small sample size, this study proved that helical CT angiography is an easier and faster technique than conventional angiography for localizing GI bleeding and is useful as a guide for subsequent selective angiography [4]. Subsequently, Yoon et al [5] demonstrated an accuracy of 88.5 % (22/26) for the detection of acute GI bleeding using multidetector row CT. Wu et al [3] and Anthony et al [2] proposed that CT angiography should be used routinely for the investigation of patients who meet the criteria for acute GI hemorrhage due to its high accuracy and the ability to show the precise location and etiology of bleeding, thereby directing management.…”

Section: Discussionmentioning

confidence: 65%

Outcome Following a Negative CT Angiogram for Gastrointestinal Hemorrhage

Chan

Tse

Dixon

et al. 2014

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

Objective This study was designed to evaluate the role of a negative computed tomography angiogram (CTA) in patients who present with gastrointestinal (GI) hemorrhage. Methods A review of all patients who had CTAs for GI hemorrhage over an 8-year period from January 2005 to December 2012 was performed. Data for patient demographics, location of hemorrhage, hemodynamic stability, and details of angiograms and/or the embolization procedure were obtained from the CRIS/PACS database, interventional radiology database, secure electronic medical records, and patient's clinical notes. Results A total of 180 patients had 202 CTAs during the 8-year period: 87 CTAs were performed for upper GI hemorrhage (18 positive for active bleeding, 69 negative) and 115 for lower GI hemorrhage (37 positive for active bleeding, 78 negative); 58.7 % (37/63) of patients with upper GI bleed and 77.4 % (48/62) of patients with lower GI bleed who had an initial negative CTA did not rebleed without the need for radiological or surgical intervention. This difference was statistically significant (p = 0.04). The relative risk of rebleeding, following a negative CTA, in lower GI bleeding versus upper GI bleeding patients is 0.55 (95 % confidence interval 0.32-0.95). Conclusions Patients with upper GI bleed who had negative CTAs usually require further intervention to stop the bleeding. In contrast, most patients presenting with lower GI hemorrhage who had a negative first CTA were less likely to rebleed.

show abstract

Section: Discussionmentioning

confidence: 65%

Outcome Following a Negative CT Angiogram for Gastrointestinal Hemorrhage

Chan

Tse

Dixon

et al. 2014

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

show abstract

“…The value of CT in patients with lower GI bleeding in the clinical setting has been reported only infrequently, and studies investigating the ability of CT to detect the source of upper GI bleeding are limited to a few case reports. Ettorre [9] reported their experience in 18 patients with acute lower GI bleeding after intra-arterial injection of CM through an angiography catheter positioned in the celiac trunk. With this invasive technique, the authors found the bleeding source in 72% of the patients.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, recent studies have suggested a good performance for the detection of sources of GI bleeding using CT. However, reports about the usefulness of CT in evaluating lower GI bleeding so far have been limited in number and scope [5][6][7][8][9], and studies on the utility of CT for the evaluation of patients with upper GI bleeding are mostly restricted to a few anecdotal reports [10,11]. In addition, CT protocols vary considerably across the different studies.…”

Section: Introductionmentioning

confidence: 99%

“…Some investigators used water as oral contrast media (CM) [6] whereas other administered oral iodinated CM [7]. Some authors performed unenhanced and arterial phase CT imaging [4][5][6] whereas others have shown good conspicuity for bleeding source detection with CT after intra-arterial injection of CM with an angiography catheter placed in the celiac trunc [9]. Moreover, most of the above-mentioned studies [4,5,7,8] did not assess if CT is a method that can provide a comprehensive workup of the disease by detecting both the bleeding source and the underlying etiology, and did not investigate the role of CT in the diagnostic process of patients with GI bleeding.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Acute gastrointestinal bleeding: detection of source and etiology with multi-detector-row CT

et al. 2006

View full text Add to dashboard Cite

This study was conducted to determine the ability of multidetector-row computed tomography (CT) to identify the source and etiology of acute gastrointestinal bleeding. Eighteen patients with acute upper (n=10) and lower (n=8) gastrointestinal bleeding underwent 4-detector-row CT (n=6), 16-detectorrow CT (n=11), and 64-slice CT (n=1) with an arterial and portal venous phase of contrast enhancement. Unenhanced scans were performed in nine patients. CT scans were reviewed to determine conspicuity of bleeding source, underlying etiology, and for potential causes of false-negative prospective interpretations. Bleeding sources were prospectively identified with CT in 15 (83%) patients, and three (17%) bleeding sources were visualized in retrospect, allowing the characterization of all sources of bleeding with CT. Contrast extravasation was demonstrated with CT in all 11 patients with severe bleeding, but only in 1 of 7 patients with mild bleeding. The etiology could not be identified on unenhanced CT scans in any patient, whereas arterial-phase and portal venous-phase CT depicted etiology in 15 (83%) patients. Underlying etiology was correctly identified in all eight patients with mild GI bleeding. Multidetector-row CT enables the identification of bleeding source and precise etiology in patients with acute gastrointestinal bleeding.

show abstract

“…[28][29][30] Ettorre et al performed CT angiography with direct SMA catheterization, which is an invasive technique with good results when depicting extravasation of CM. 32 Ernst et al found MDCT scan to be of intermediate sensitivity for acute lower GI bleeding, 33 but their study focused on many different signs ranging from stranding to active evidence of bleeding. The prospective study by Yoon et al demonstrates high sensitivity and specificity of MDCT scan compared to angiography.…”

mentioning

confidence: 99%

Multidetector computed tomography in acute lower gastrointestinal bleeding

Milot¹,

Palma²,

Mihaila³

et al. 2010

RMI

View full text Add to dashboard Cite

Background:The aim of this study is to evaluate multidetector computed tomography (MDCT) in acute massive lower gastrointestinal bleeding, with endoscopy and surgery as reference examinations. Methods: A single-center retrospective study involving 34 patients with acute massive lower gastrointestinal bleeding was carried out. All patients were evaluated by MDCT scan then endoscopic or surgical examinations. Sensitivity, specificity, and positive and negative predictive values of MDCT scan were calculated using the extravasation of the contrast agent as the main criterion. Results: Extravasation of the contrast agent was found in 30 of 34 patients (88%). The bleeding site seen on CT was always the same as on endoscopic or surgical examinations (100%). Sensitivity of MDCT scan was 94%, specificity 100%, positive predictive value 100%, and negative predictive value 50% (P , 0.001). Twelve diverticulum bleedings were seen on MDCT scan compared with 13 (92%) on endoscopic or surgical examinations. Angiodysplasia was overestimated by MDCT scan. Conclusion: MDCT scan appears to be an excellent tool to find and localize the bleeding site in cases of acute massive lower gastrointestinal disease.

show abstract

Helical CT angiography in gastrointestinal bleeding of obscure origin.

Cited by 125 publications

References 0 publications

Outcome Following a Negative CT Angiogram for Gastrointestinal Hemorrhage

Outcome Following a Negative CT Angiogram for Gastrointestinal Hemorrhage

Acute gastrointestinal bleeding: detection of source and etiology with multi-detector-row CT

Multidetector computed tomography in acute lower gastrointestinal bleeding

Contact Info

Product

Resources

About