Korean J Gastroenterol.  2008 May;51(5):298-304.

Role of Multi-detector Row Computed Tomography for Localization of Acute Lower Gastrointestinal Bleeding

• Lee SM
• Kim TO
• Park HY
• Kim KY
• Kim GH
• Kang DH
• Song GA
• Kim S

Abstract

BACKGROUND/AIMS: Recent studies have shown good performance for the detection of sources of gastrointestinal bleeding using multi-detector row computed tomography (MDCT). However, there are limited reports about the role of MDCT for localization of acute lower gastrointestinal (GI) bleeding. The purpose of this study was to evaluate the role of MDCT for detection and localization of acute lower gastrointestinal bleeding.
METHODS
A total of 49 patients underwent MDCT examination for the evaluation of acute lower GI bleeding were investigated prospectively. Sensitivity, specificity, positive and negative predictive values of MDCT for the detection of acute lower GI bleeding were assessed. Colonoscopy, angiography, RBC scan or postoperative results were adopted as the reference standard. RESULTS: Sensitivity, specificity, positive and negative predictive values of MDCT for the detection of acute lower GI bleeding were 72.7%, 80%, 93.9% and 25%, respectively. Eighteen patients experienced massive bleeding and 5 of them could not undergo the colonoscopic examination due to massive bleeding. MDCT detected the bleeding focuses in all of 5 patients. CONCLUSIONS: MDCT is useful for the localization of acute lower GI bleeding. The procedure is brief, less invasive, and relatively accurate diagnostic method. Moreover, positive finding will allow directed therapeutic procedure such as angiography.

Keyword

Acute lower gastrointestinal bleeding; Multi-detector row computed tomography (MDCT)

MeSH Terms

Acute Disease
Angiography
Gastrointestinal Hemorrhage/etiology/*radiography
Humans
Predictive Value of Tests
Prospective Studies
Reproducibility of Results
*Tomography, Spiral Computed