Upper gastrointestinal bleeding other imaging findings: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Upper gastrointestinal bleeding}} | {{Upper gastrointestinal bleeding}} | ||
{{CMG}} ; {{AE}} {{ADG}} | |||
{{CMG}}; {{AE}} | |||
==Overview== | ==Overview== | ||
==Other Imaging Findings== | |||
In cases where the source of bleeding is unidentified after upper endoscopy, the utilization of subsequent diagnostic modalities depends upon the hemodynamic stability of the patient. Other diagnostic studies include:<ref name="pmid6604219">{{cite journal |vauthors=Steer ML, Silen W |title=Diagnostic procedures in gastrointestinal hemorrhage |journal=N. Engl. J. Med. |volume=309 |issue=11 |pages=646–50 |year=1983 |pmid=6604219 |doi=10.1056/NEJM198309153091106 |url=}}</ref><ref name="pmid3094466">{{cite journal |vauthors=Browder W, Cerise EJ, Litwin MS |title=Impact of emergency angiography in massive lower gastrointestinal bleeding |journal=Ann. Surg. |volume=204 |issue=5 |pages=530–6 |year=1986 |pmid=3094466 |pmc=1251335 |doi= |url=}}</ref><ref name="pmid2334015">{{cite journal |vauthors=Hunter JM, Pezim ME |title=Limited value of technetium 99m-labeled red cell scintigraphy in localization of lower gastrointestinal bleeding |journal=Am. J. Surg. |volume=159 |issue=5 |pages=504–6 |year=1990 |pmid=2334015 |doi= |url=}}</ref> | |||
*CT angiography | |||
*Catheter angiography | |||
*Radionuclide imaging | |||
{| class="wikitable" | |||
! | |||
!CT angiography | |||
!Catheter angiography | |||
!Radionuclide imaging | |||
|- | |||
|Bleeding at rates | |||
detection | |||
|At least 0.5 mL/min | |||
|0.5 to 1.5 mL/min | |||
|0.1 mL/min | |||
|- | |||
|Indications | |||
| | |||
* Hemodynamically stable | |||
* Endoscopy undiagnostic | |||
| | |||
* Endoscopy not feasible due to severe bleeding with hemodynamic instability | |||
* Persistent or recurrent GI bleeding | |||
* Non-diagnostic upper endoscopy | |||
| | |||
|- | |||
|Advantages | |||
| | |||
* Minimally invasive | |||
* Demonstrate neoplasms or vascular malformations | |||
* | |||
* | * Can provide evidence of recent bleeding | ||
** | | | ||
** | * Diagnostic and therapeutic | ||
** | * Allows for infusion of vasoconstrictive drugs and/or embolization. | ||
* Does not require bowel preparation. | |||
| | |||
* Most sensitive imaging modality for GI bleeding | |||
* More commonly utilized for investigation of patients with obscure, intermittent bleeding | |||
|- | |||
|Disadvantages | |||
| | |||
* Lacks therapeutic capability | |||
* Risk of contrast induced nephropathy in patients with renal impairment and contrast allergy | |||
| | |||
* Access-site hematoma or pseudoaneurysm | |||
* Arterial dissection | |||
* Spasm, bowel ischemia | |||
* Contrast-induced nephropathy or allergic reaction | |||
| | |||
* Poor anatomic localization of the bleeding site | |||
* Unable to diagnose the pathological cause of GI bleeding | |||
|} | |||
==References== | ==References== | ||
Revision as of 17:45, 6 November 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
Other Imaging Findings
In cases where the source of bleeding is unidentified after upper endoscopy, the utilization of subsequent diagnostic modalities depends upon the hemodynamic stability of the patient. Other diagnostic studies include:[1][2][3]
- CT angiography
- Catheter angiography
- Radionuclide imaging
| CT angiography | Catheter angiography | Radionuclide imaging | |
|---|---|---|---|
| Bleeding at rates
detection |
At least 0.5 mL/min | 0.5 to 1.5 mL/min | 0.1 mL/min |
| Indications |
|
|
|
| Advantages |
|
|
|
| Disadvantages |
|
|
|
References
- ↑ Steer ML, Silen W (1983). "Diagnostic procedures in gastrointestinal hemorrhage". N. Engl. J. Med. 309 (11): 646–50. doi:10.1056/NEJM198309153091106. PMID 6604219.
- ↑ Browder W, Cerise EJ, Litwin MS (1986). "Impact of emergency angiography in massive lower gastrointestinal bleeding". Ann. Surg. 204 (5): 530–6. PMC 1251335. PMID 3094466.
- ↑ Hunter JM, Pezim ME (1990). "Limited value of technetium 99m-labeled red cell scintigraphy in localization of lower gastrointestinal bleeding". Am. J. Surg. 159 (5): 504–6. PMID 2334015.