Maria Vega Garcia Blazquez, Presenter: Nothing to Disclose

Agustina Vicente Bartulos MD, Abstract Co-Author: Nothing to Disclose

Luis Gorospe Sarasua, Abstract Co-Author: Nothing to Disclose

Rut Romera Sanchez RT, Abstract Co-Author: Nothing to Disclose

Javier Zamora Romero, Abstract Co-Author: Nothing to Disclose

Ana Royuela Vicente, Abstract Co-Author: Nothing to Disclose

To assess factors that might be related with presence of active bleeding on CT-angiography performed in patients with acute episode of lower gastrointestinal bleeding.

Prospective study (2 years) over 105 patients with AGIB and CT-angiography is performed according to agreed protocol (baseline, arterial and venous phases). Positivity in CT angiography is assessed by the presence of contrast extravasation active arterial and/or venous phases. The following variables were collected: age, sex, history of prior episodes of AIB, anticoagulant/anti-platelet treatment; non steroidal anti-inflammatory drugs; severity of AIB (severe / moderate / mild); hemodynamic instability; need for transfusion; location and cause of the bleeding. An endoscopy or/and arteriography or/and surgery were used as gold standard/benchmarks. Data analysis was performed using Chi-square, Fisher and U Mann-Whitney test. SPSS 15 software was used.  

105 patients (49 males / 56 females) with average age of 73 were recruited. The CT-angiography was positive in 28%. There is no statistically significant difference between age, sex or previous history of gastrointestinal bleeding. There is a higher risk of active bleeding on CT angiography although a statistically significant relationship was not reachet in patients taking anticoagulant/anti-platelet therapy (36.7% in positive CTs versus in 21.4% negatives); non steroidal anti-inflammatory drugs (35.7 vs. 27.5%); hemodynamic instability (risk different between the two categories,15%); need for transfusion (39% vs 23.5%); the localization in the colon (71.4 vs 28%). There is a statistically significant association (p <0.001) between serious-massive hemorrhage and the likelihood of gastrointestinal bleeding.  

Severe gastrointestinal bleeding could be a predictor of active bleeding on CT-angiography. It is likely that positivity CT factors as anti-platelet therapy, non steroidal anti-inflammatory drugs, transfusion requirements, and localization in the colon….could reach statistical significance with an increased sample size.  

The multidetector CT-angiography appears to be a promising diagnostic tool in emergency AGIB. Sould be the first test to be performed thanks to its characteristics availability, speed, does not require preparation. Certain patient characteristics may help predict the positive test. 

Garcia Blazquez, M, Vicente Bartulos, A, Gorospe Sarasua, L, Romera Sanchez, R, Zamora Romero, J, Royuela Vicente, A, Acute Gastrointestinal Bleeding (AGIB)—Can we Predict Bleeding on MDCT Angiography?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14012639.html