Diagnosis of Acute Gastrointestinal Hemorrhage and Acute Mesenteric Ischemia in the Era of Multi-Detector Row CT
Section snippets
Acute gastrointestinal hemorrhage
Acute gastrointestinal (GI) hemorrhage is a commonly encountered symptom in both the primary care and emergency care settings. Acute GI hemorrhage is classified as upper or lower depending on the location of the source of the bleed in reference to the ligament of Treitz.1 Upper GI hemorrhage is more common than lower GI hemorrhage. The annual incidence of upper GI hemorrhage ranges from 40 to 150 episodes per 100,000 persons, and the annual incidence of lower GI hemorrhage ranges from 20 to 27
Acute mesenteric ischemia
Although bowel ischemia is a complex disease with many manifestations, it is essentially caused by a significant reduction in the blood supply to the mesenteric circulation. Acute bowel ischemia represents one of the most dangerous abdominal conditions presenting in the acute care setting.25, 26 Investigators suggest that only 1% of acute abdomen hospitalizations are secondary to acute bowel ischemia.27 Although acute bowel ischemia is an uncommonly encountered entity in the emergency
Summary
Although mesenteric ischemia is not one of the most commonly encountered entities in the acute care setting, it is associated with a high mortality rate. Thus, rapid and accurate diagnosis is imperative. The variable clinical and radiologic presentations and appearances of mesenteric ischemia pose a challenge to both clinicians and radiologists. Strong clinical-imaging communication and correlation is important to detect, diagnose, and treat this entity in the appropriate time course. CT is
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Cited by (10)
ACR Appropriateness Criteria<sup>®</sup> Nonvariceal Upper Gastrointestinal Bleeding
2017, Journal of the American College of RadiologyCitation Excerpt :In this clinical context, it is often not feasible to wait for the gastroenterologist or interventionalist because it may be critical to expeditiously identify the source of bleeding. Multiphase MDCT can effectively identify life-threatening hemorrhage, is a highly available modality, and is minimally invasive [62,122]. Hemorrhage that appears first at arterial or portal venous phase is active and should be considered life threatening, as opposed to a contained bleed, which is visualized on equilibrium phase [123].
Acute gastrointestinal hemorrhage: Radiologic diagnosis and management
2013, Canadian Association of Radiologists JournalCitation Excerpt :At present, the triphasic technique is recommended for optimal sensitivity and specificity because the radiation dose is a lesser concern in the setting of severe GI bleeding, which may be life threatening. Interpretation of the CT study is aided by use of multiplanar reformats and maximum intensity projection images [42,45]. Active bleeding is required for a positive CT.
Duodenal angiodysplasia: a case report
2021, Egyptian Journal of Radiology and Nuclear MedicineCT for evaluation of acute gastrointestinal bleeding
2018, Radiographics