William Robert Lees MBBS, Abstract Co-Author: Nothing to Disclose

Harpreet K. Hyare MBBS, Presenter: Nothing to Disclose

Jocelyn Simon Brookes MBBS, Abstract Co-Author: Nothing to Disclose

Michael John Guiney MD, Abstract Co-Author: Nothing to Disclose

Sharmini Desigan MBBCh, Abstract Co-Author: Nothing to Disclose

Major arterial haemorrhage after severe acute pancreatitis is uncommon but is associated with high mortality. Visceral angiography is the accepted gold standard for the localization of GI tract bleeding. The aim of this study was to determine whether CTA can replace conventional angiography in the diagnosis and localization of the bleeding vessel.

29 studies were performed in 25 patients where a CT angiogram was performed in the preceeding 24 hours before conventional angiography. All CT angiograms were performed on a 4 detector row scanner at a 1 mm collimation with reconstruction on a 3D workstation. (Siemens, Erlangen)

Conventional angiography demostrated a pseudoaneurysm or bleeding site in 19 studies. No bleeding was seen in 9 studies. CTA demonstrated the site and type of bleeding in 18/19 positive angiograms. CT also demonstrated bleeding in 1 study not shown on the conventional angiogram

CTA is as sensitive at detecting GI bleeding as conventional angiography. Our vascular interventional radiologists now insist on a CTA before they will perform a visceral angiogram. It is diagnostic, it shows the type and site of bleeding and it provides a roadmap for the subsequent endovascular therapy.

Lees, W, Hyare, H, Brookes, J, Guiney, M, Desigan, S, CT Angiography or Visceral Angiography in the Diagnosis of GI Tract Haemorrhage?.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4418290.html