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Multidetector computed tomography in acute lower gastrointestinal bleeding

Authors Palma J, Mihaila M, Pilleul F

Published 24 November 2010 Volume 2010:3 Pages 107—113


Review by Single anonymous peer review

Peer reviewer comments 2

John Palma, Marius Mihaila, Frank Pilleul
Département de Radiologie Digestive et des Urgences, Hôpital Edouard Herriot, Hospices Civils de Lyon, CHU, Lyon, France

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.

Keywords: MDCT, acute lower gastrointestinal bleeding, extravasation, contrast agent

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