Milagros Marti De Gracia MD, Presenter: Nothing to Disclose

Jose Maria Artigas MD, Abstract Co-Author: Nothing to Disclose

Jorge A. Soto MD, Abstract Co-Author: Researcher, General Electric Company

Ana Veron MD, Abstract Co-Author: Nothing to Disclose

Gonzalo Garzon, Abstract Co-Author: Nothing to Disclose

To determine the clinical utility of CT angiography as the initial diagnostic procedure in patients presenting with acute lower intestinal bleeding (ALIB).

This is a prospective study conducted over 17 months of 70 consecutive patients who presented to the emergency room with the chief complaint of ALIB. All CT angiography examinations were performed with 64- (n= 22) or 16 (n=48) detector scanners, using a three-phase examination: pre-contrast (low-radiation dose), arterial and portal venous phases. Findings recorded on CT angiography were: presence of active bleeding, evidence of recent bleeding and potential source of bleeding. We determined the subsequent disposition of the patients, including additional diagnostic tests and therapeutic interventions performed, as well as final diagnosis.

Active bleeding was found in 26 patients, signs of recent bleeding with no active bleeding in 5 patients, and lesions potentially responsible for the bleeding (without active or recent bleeding) in 30 patients. Nine patients had none of these findings. Management of patients after admission was as follows: angiography and embolization (n=8), therapeutic endoscopy (n=7), surgery (n=8), diagnostic endoscopy (n=10), other procedures (n=2) and no other emergency procedure (n=35). All patients with evidence of active bleeding on CTA underwent emergency intervention for hemostasis, except three: one death and in two patients the bleeding stopped spontaneously. Compared with the standard of reference (angiography, surgery, endoscopy or clinical follow-up), CTA made the correct diagnosis in 62 (88.6%) patients.

CTA is a useful initial diagnostic test for triaging patients presenting to the emergency room with ALIB.  

 Diagnostic reliability and availability of MDCT in Emergency Radiology Department allows their routinely use as initial diagnostic technique in Acute Lower Intestinal Bleeding.

Marti De Gracia, M, Artigas, J, Soto, J, Veron, A, Garzon, G, Clinical Utility of CT Angiography as the Initial Step for Acute Lower Intestinal Bleeding.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034497.html