MDCT angiography and transcatheter embolization in management of acute gastrointestinal bleeding

Abstract

Acute gastrointestinal (GI) bleeding is an important cause of emergency hospital admissions, with its related morbidity and mortality. The availability of endoscopic equipment has had an important effect on the rapid identification and treatment of the bleeding source. Multidetector computed tomography (MDCT) allows direct demonstration and visualization of the bleeding source and its characterization. The information provided by MDCT angiography before attempts at therapeutic angiographic procedures leads to faster selective catheterization of bleeding vessels. The purpose of this study was to show the role of MDCT and catheter embolization in management of acute GI bleeding.
Materials and methods: This is a retrospective study that included 57 patients referred in 4 years with active gastrointestinal bleeding. MDCT was performed in 43 cases, while 14 patients didn’t have CT angiography and proceeded straight to angiography.
Results: 37 patients had positive MDCT findings, of which 27 cases had positive bleed on angiography, and 10 did not show active bleeding on angiography. 6 patients had a negative MDCT and did not proceed to angiography. 14 patients did not have aMDCT and proceeded straight to angiography; 6 of them showed active bleeding on angiography.
Conclusion: MDCT is an excellent technique before angiography and embolization in cases with acute gastrointestinal bleeding. Transcatheter embolization is an effective tool for control of GI bleed.