Abstract
Contrast-enhanced multidetector row helical computed tomography (MDCT) scanning is establishing itself as a rapid, noninvasive, and accurate diagnostic method in suspected acute gastrointestinal bleeding. Active bleeding can be depicted as an area of focal high attenuation within the bowel lumen on arterial phase MDCT images. New MDCT technologies facilitate three-dimensional image reconstruction, and higher temporal resolution is available with new MDCT scanner generations. This allows for the acquisition of arterial- and portal-venous phase images of the whole abdomen, revealing potential bleeding sources and simultaneously depict morphological changes in the abdomen, such as intestinal tumors. This article gives an overview of available diagnostic modalities in assessing gastrointestinal (GI) tract hemorrhage, with a special emphasis on new MDCT technology.
Similar content being viewed by others
References
Longstreth GF (1997) Epidemiology and outcome of patients hospitalized with acute lower gastrointestinal hemorrhage: a population-based study. Am J Gastroenterol 92: 419–424
Sanders DS, Perry MJ, Jones SG, et al. (2004) Effectiveness of an upper-gastrointestinal hemorrhage unit: a prospective analysis of 900 consecutive cases using the Rockall score as a method of risk standardisation. Eur J Gastroenterol Hepatol 16: 487–494
Manning-Dimmitt LL, Dimmitt SG, Wilson GR (2005) Diagnosis of gastrointestinal bleeding in adults. Am Fam Physician 71: 1339–1346
Rios A, Montoya MJ, Rodriguez JM, et al. (2007) Severe acute lower gastrointestinal bleeding: risk factors for morbidity and mortality. Langenbecks Arch Surg 392: 165–171
Walsh RM, Anain P, Geisinger M, et al. (1999) Role of angiography and embolization for massive gastroduodenal hemorrhage. J Gastrointest Surg 3: 61–65
Ernst O, Bulois P, Saint-Drenant S, Leroy C, Paris JC, Sergent G (2003) Helical CT in acute lower gastrointestinal bleeding. Eur Radiol 13: 114–117
Tew K, Davies RP, Jadun CK, Kew J (2004) MDCT of acute lower gastrointestinal bleeding. AJR Am J Roentgenol 182: 427–430
Sabharwal R, Vladica P, Chou R, Law WP (2006) Helical CT in the diagnosis of acute lower gastrointestinal hemorrhage. Eur J Radiol 58: 273–279
Junquera F, Quiroga S, Saperas E, et al. (2000) Accuracy of helical computed tomographic angiography for the diagnosis of colonic angiodysplasia. Gastroenterology 119: 293–299
Yoon W, Jeong YY, Shin SS, et al. (2006) Acute massive gastrointestinal bleeding: detection and localization with arterial phase multi-detector row helical CT. Radiology 239: 160–167
Scheffel H, Pfammatter T, Wildi S, Bauerfeind P, Marincek B, Alkadhi H (2006) Acute gastrointestinal bleeding: detection of source and etiology with multi-detector-row CT. Eur Radiol [Epub ahead of print]
Zuckerman GR, Prakash C (1998) Acute lower intestinal bleeding: part I: clinical presentation and diagnosis. Gastrointest Endosc 48: 606–617
Zuckerman GR, Prakash C (1999) Acute lower intestinal bleeding. Part II: etiology, therapy, and outcomes. Gastrointest Endosc 49: 228–238
Cellier C, Tkoub M, Gaudric M, et al. (1998) [Comparison of push-type endoscopy and barium transit study of the small intestine in digestive bleeding and unexplained iron-deficiency anemia]. Gastroenterol Clin Biol 22: 491–494
Davis BR, Harris H, Vitale GC (2005) The evolution of endoscopy: wireless capsule cameras for the diagnosis of occult gastrointestinal bleeding and inflammatory bowel disease. Surg Innov 12: 129–133
Lai LH, Wong GL, Chow DK, Lau JY, Sung JJ, Leung WK (2006) Inter-observer variations on interpretation of capsule endoscopies. Eur J Gastroenterol Hepatol 18: 283–286
Diehl SJ, Ko HS, Dominguez E, et al. (2007) [Negative endoscopy and MSCT findings in patients with acute lower gastrointestinal hemorrhage: Value of (99m)Tc erythrocyte scintigraphy.]. Radiologe 47: 64–70
Willmann JK, Roos JE, Platz A, et al. (2002) Multidetector CT: detection of active hemorrhage in patients with blunt abdominal trauma. AJR Am J Roentgenol 179: 437–444
Sos TA, Lee JG, Wixson D, Sniderman KW (1978) Intermittent bleeding from minute to minute in acute massive gastrointestinal hemorrhage: arteriographic demonstration. AJR Am J Roentgenol 131: 1015–1017
van Leerdam ME, Vreeburg EM, Rauws EA, et al. (2003) Acute upper GI bleeding: did anything change? Time trend analysis of incidence and outcome of acute upper GI bleeding between 1993/1994 and 2000. Am J Gastroenterol 98: 1494–1499
Kuhle WG, Sheiman RG (2003) Detection of active colonic hemorrhage with use of helical CT: findings in a swine model. Radiology 228: 743–752
Krestan CR, Pokieser P, Wenzl E, Leitha T (2000) Localization of gastrointestinal bleeding with contrast-enhanced helical CT. AJR Am J Roentgenol 174: 265–266
Singer AA (1995) Value of CT in localizing site of gastrointestinal hemorrhage following negative angiography. Abdom Imaging 20: 31–32
Ettorre GC, Francioso G, Garribba AP, Fracella MR, Greco A, Farchi G (1997) Helical CT angiography in gastrointestinal bleeding of obscure origin. AJR Am J Roentgenol 168: 727–731
Sivit CJ, Peclet MH, Taylor GA (1989) Life-threatening intraperitoneal bleeding: demonstration with CT. Radiology 171: 430
Lane MJ, Katz DS, Shah RA, Rubin GD, Jeffrey RB Jr (1998) Active arterial contrast extravasation on helical CT of the abdomen, pelvis, and chest. AJR Am J Roentgenol 171: 679–685
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Jaeckle, T., Stuber, G., Hoffmann, M. et al. Acute gastrointestinal bleeding: Value of MDCT. Abdom Imaging 33, 285–293 (2008). https://doi.org/10.1007/s00261-007-9263-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00261-007-9263-8