Role of triphasic CT imaging in detection of acute non variceal GIT bleeding

Mohamed Ahmed, Ghada Abd Elsabour; Hakeem Seif, Hany Mohammed Abdel; Abdu, Ehab Fawzy; Qenawy, Omran Khodary

doi:10.4103/jcmrp.jcmrp_144_21

Role of triphasic CT imaging in detection of acute non variceal GIT bleeding

Authors

Abstract

Background
Gastrointestinal bleeding (GIB) is considered a dangerous trouble, an important etiology for hospital admissions, and has a rate of mortality of about 6%–10% for bleeding from the upper GI tract (GIT) and about 4% for bleeding from the lower GIT. It needs combined efforts involving gastroenterology, endoscopy, surgery, and radiology departments.
Aim of the work
To assess the role of multidetector computed tomography (CT) in diagnosing acute nonvariceal bleeding from the GI tract.
Patients and methods
Fifty patients presented by acute nonvariceal GIT bleeding after exclusion of cases that had impaired renal functions or with terminal liver failure, pregnancy, patients who have sensitivity to contrast medium, and patients who were diagnosed as variceal bleeding; they underwent Multi slice computed tomography (MSCT) angiography after resuscitation of patients with shock, monitoring for unstable patients. Images were acquired with slice thickness 5 mm for unenhanced phase and 1.25 mm for arterial phase and portovenous phases, pitch 1.375, 300 MA, 120 kVp, and rotation time 0.7 s. Images acquired were reconstructed for sagittal, coronal, Maximum intensity projection (MIP), and volume-rendering images.
Results
MSCT helped in the diagnosis of the source and/or the cause of bleeding in 66% of examined cases ( = 33), whereas CT could not detect the cause of bleeding in 34% of cases ( = 17).
Conclusion
CT angiography (CTA) can act as a good first-line screening method in the localization and detection of GIB sites. CTA can be used to triage patients with active GIB and give an idea for required further examination.

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