Victoria Chan MBChB, Presenter: Nothing to Disclose

Donald Man Lap Tse MRCP, FRCR, Abstract Co-Author: Nothing to Disclose

Shaheen Dixon MBBS, FRCR, Abstract Co-Author: Nothing to Disclose

Vivek Shrivastava MBBS, Abstract Co-Author: Nothing to Disclose

Charles Ross Tapping MBBCh, FRCR, Abstract Co-Author: Nothing to Disclose

Rafiuddin Patel MBChB, FRCR, Abstract Co-Author: Nothing to Disclose

Mark Bratby MRCP, FRCR, Abstract Co-Author: Nothing to Disclose

Suzie Anthony FRCR, Abstract Co-Author: Nothing to Disclose

Raman Uberoi MBChB, FRCR, Abstract Co-Author: Nothing to Disclose

To evaluate the role of a negative computed tomography angiogram (CTA) in patients who present with gastrointestinal (GI) haemorrhage.

A review of all patients who had CTAs for GI hemorrhage over an eight-year period from January 2005 to December 2012 was performed. Data on patient demographics, location of hemorrhage, hemodynamic stability and details of angiograms and/or the embolization procedure were obtained from the CRIS/PACS database, interventional radiology database, secure electronic medical records and patient’s clinical notes.

202 CTAs were performed in 180 patients over the eight-year period. 87 CTAs were performed for upper GI hemorrhage (18 positive for active bleeding, 69 negative) and 115 for lower GI hemorrhage (37 positive for active bleeding, 78 negative). 58.7% (37/63) of patients with upper GI bleed and 77.4% (48/62) of patients with lower GI bleed who had an initial negative CTA did not rebleed without the need for radiological or surgical intervention. This difference was statistically significant (p = 0.04). The relative risk of rebleeding, following a negative CTA, in lower GI bleeding vs upper GI bleeding patients is 0.55 (95% confidence interval 0.32 – 0.95).

Patients with upper GI bleed who had negative CTAs usually require further intervention to stop the bleeding. In contrast, most patients presenting with lower GI hemorrhage who had a negative first CTA were less likely to rebleed.

Negative CTA is a good indicator that patients with lower GI hemorrhage with a negative first CTA are much more likely to settle spontaneously without the need for intervention, compared with patients with upper GI hemorrhage.

Chan, V, Tse, D, Dixon, S, Shrivastava, V, Tapping, C, Patel, R, Bratby, M, Anthony, S, Uberoi, R, Outcome Following a Negative CT Angiogram for Gastrointestinal Haemorrhage.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14018409.html