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CT Angiography in Gastrointestinal Bleeding
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CT Angiography in Gastrointestinal Bleeding
, CTA Abdomen for Lower GI Bleed
See Also
Gastrointestinal Bleeding
Upper Gastrointestinal Bleeding
Lower Gastrointestinal Bleeding
Angiography in GI Bleeding
Radionuclide Red Cell Scan
Indications
Brisk
Gastrointestinal Bleeding
obscures source on
Colonoscopy
Gastrointestinal Bleeding
with a patient too unstable for endoscopy
Acute, high risk
Lower Gastrointestinal Bleeding
while awaiting preparation for endoscopy
Imaging
CT Angiography WITHOUT
Oral Contrast
(preferred)
Do not use high density oral or rectal contrast
Oral Contrast
obscures bleeding
Oral Contrast
not needed for other causes (e.g.
Diverticulitis
,
Ischemic Bowel
)
Evaluation
CTA may be test of choice in heavy
Lower GI Bleed
ing in which endoscopy cannot be performed
CTA may direct exploratory laparotomy (identifying source)
PACS imaging density >90
Hounsfield Unit
s (HU) is consistent with blood on CTA
Efficacy
Test Sensitivity
for
Gastrointestinal Bleeding
: 38% (similar to RBC Scan)
CTA localizes the bleeding source in 53% (contrast with 30% for RBC Scan)
CTA without bleeding predicts lower recurrent bleeding rate
References
Broder (2022) Crit Dec Emerg Med 31(2): 14-5
Feuerstein (2016) AJR Am J Roentgenol 207(3): 578-84 [PubMed]
Kennedy (2010) J Vasc Interv Radiol 21(6):848-55 [PubMed]
Chan (2015) Cardiovasc Intervent Radiol 28(2): 329-35 [PubMed]
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