CT for evaluation of acute gastrointestinal bleeding

Michael Wells, Stephanie L. Hansel, David H. Bruining, Joel Garland Fletcher, Adam T. Froemming, John M. Barlow, Jeff L. Fidler

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Acute gastrointestinal (GI) bleeding is common and necessitates rapid diagnosis and treatment. Bleeding can occur anywhere throughout the GI tract and may be caused by many types of disease. The variety of enteric diseases that cause bleeding and the tendency for bleeding to be intermittent may make it difficult to render a diagnosis. The workup of GI bleeding is frequently prolonged and expensive, with examinations commonly needing to be repeated. The use of computed tomography (CT) for evaluation of acute GI bleeding is gaining popularity because it can be used to rapidly diagnose active bleeding and nonbleeding bowel disease. The CT examinations used to evaluate acute GI bleeding include CT angiography and multiphase CT enterography. Understanding the clinical evaluation of acute GI bleeding, including the advantages and limitations of endoscopic evaluation, is necessary for the appropriate selection of patients who may benefit from CT. Multiphase CT enterography is used primarily to evaluate stable patients who have undergone upper and lower endoscopy without identification of a bleeding source. CT angiography is used to examine stable and unstable patients who respond to resuscitation, are believed to be actively bleeding, and are considered unlikely to have an upper GI source of hemorrhage. In the emergent setting, CT may yield critical information regarding the presence, location, and cause of active bleeding—data that can guide the choice of subsequent therapy. Recent developments in the use of and techniques for performing CT angiography have made it a potential first-line tool for evaluating acute GI bleeding.

Original languageEnglish (US)
Pages (from-to)1089-1107
Number of pages19
JournalRadiographics
Volume38
Issue number4
DOIs
StatePublished - Jul 1 2018

Fingerprint

Tomography
Hemorrhage
Gastrointestinal Hemorrhage
Resuscitation
Patient Selection
Endoscopy
Gastrointestinal Tract
Therapeutics

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Wells, M., Hansel, S. L., Bruining, D. H., Fletcher, J. G., Froemming, A. T., Barlow, J. M., & Fidler, J. L. (2018). CT for evaluation of acute gastrointestinal bleeding. Radiographics, 38(4), 1089-1107. https://doi.org/10.1148/rg.2018170138

CT for evaluation of acute gastrointestinal bleeding. / Wells, Michael; Hansel, Stephanie L.; Bruining, David H.; Fletcher, Joel Garland; Froemming, Adam T.; Barlow, John M.; Fidler, Jeff L.

In: Radiographics, Vol. 38, No. 4, 01.07.2018, p. 1089-1107.

Research output: Contribution to journalArticle

Wells, M, Hansel, SL, Bruining, DH, Fletcher, JG, Froemming, AT, Barlow, JM & Fidler, JL 2018, 'CT for evaluation of acute gastrointestinal bleeding', Radiographics, vol. 38, no. 4, pp. 1089-1107. https://doi.org/10.1148/rg.2018170138
Wells M, Hansel SL, Bruining DH, Fletcher JG, Froemming AT, Barlow JM et al. CT for evaluation of acute gastrointestinal bleeding. Radiographics. 2018 Jul 1;38(4):1089-1107. https://doi.org/10.1148/rg.2018170138
Wells, Michael ; Hansel, Stephanie L. ; Bruining, David H. ; Fletcher, Joel Garland ; Froemming, Adam T. ; Barlow, John M. ; Fidler, Jeff L. / CT for evaluation of acute gastrointestinal bleeding. In: Radiographics. 2018 ; Vol. 38, No. 4. pp. 1089-1107.
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