Outcome Following a Negative CT Angiogram for Gastrointestinal Hemorrhage

Journal Article · Wed Apr 15 04:00:00 EDT 2015 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-014-0928-8· OSTI ID:22470009

Chan, Victoria; Tse, Donald; Dixon, Shaheen ^[1]; Shrivastava, Vivek ^[2]; Bratby, Mark; Anthony, Suzie; Patel, Rafiuddin; Tapping, Charles; Uberoi, Raman ^[1]

---

1. John Radcliffe Hospital, Department of Radiology, Level 2 (United Kingdom)
2. Hull Royal Infirmary, Department of Radiology (United Kingdom)

ObjectiveThis study was designed to evaluate the role of a negative computed tomography angiogram (CTA) in patients who present with gastrointestinal (GI) hemorrhage.MethodsA review of all patients who had CTAs for GI hemorrhage over an 8-year period from January 2005 to December 2012 was performed. Data for patient demographics, location of hemorrhage, hemodynamic stability, and details of angiograms and/or the embolization procedure were obtained from the CRIS/PACS database, interventional radiology database, secure electronic medical records, and patient’s clinical notes.ResultsA total of 180 patients had 202 CTAs during the 8-year period: 87 CTAs were performed for upper GI hemorrhage (18 positive for active bleeding, 69 negative) and 115 for lower GI hemorrhage (37 positive for active bleeding, 78 negative); 58.7 % (37/63) of patients with upper GI bleed and 77.4 % (48/62) of patients with lower GI bleed who had an initial negative CTA did not rebleed without the need for radiological or surgical intervention. This difference was statistically significant (p = 0.04). The relative risk of rebleeding, following a negative CTA, in lower GI bleeding versus upper GI bleeding patients is 0.55 (95 % confidence interval 0.32–0.95).ConclusionsPatients with upper GI bleed who had negative CTAs usually require further intervention to stop the bleeding. In contrast, most patients presenting with lower GI hemorrhage who had a negative first CTA were less likely to rebleed.

• OSTI ID: 22470009
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 2 Vol. 38; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BIOMEDICAL RADIOGRAPHY
COMPUTERIZED TOMOGRAPHY
DESIGN
HAZARDS
HEMORRHAGE
MEDICAL RECORDS
PATIENTS
PERTURBED ANGULAR CORRELATION
REVIEWS
STABILITY
SURGERY
VASCULAR DISEASES
WHO