Multidetector computed tomography in acute lower gastrointestinal bleeding
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
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF]