Indian Journal of Gastroenterology

, Volume 31, Issue 2, pp 61–68

64-section multiphase CT enterography as a diagnostic tool in the evaluation of obscure gastrointestinal bleeding

Authors

    • Department of GastroenterologySher-i-Kashmir Institute of Medical Sciences
  • Showkat Ali Zargar
    • Department of GastroenterologySher-i-Kashmir Institute of Medical Sciences
  • Wasim Rashid
    • Department of GastroenterologySher-i-Kashmir Institute of Medical Sciences
  • Feroz Shaheen
    • Department of RadiodiagnosisSher-i-Kashmir Institute of Medical Sciences
  • Manjeet Singh
    • Department of RadiodiagnosisSher-i-Kashmir Institute of Medical Sciences
  • Gul Javid
    • Department of GastroenterologySher-i-Kashmir Institute of Medical Sciences
  • Sadaf Ali
    • Department of General SurgerySher-i-Kashmir Institute of Medical Sciences
  • Bashir Ahmad Khan
    • Department of GastroenterologySher-i-Kashmir Institute of Medical Sciences
  • Ghulam Nabi Yattoo
    • Department of GastroenterologySher-i-Kashmir Institute of Medical Sciences
  • Altaf Shah
    • Department of GastroenterologySher-i-Kashmir Institute of Medical Sciences
  • Ghulam Mohamad Gulzar
    • Department of GastroenterologySher-i-Kashmir Institute of Medical Sciences
  • Mushtaq Ahmed Khan
    • Department of GastroenterologySher-i-Kashmir Institute of Medical Sciences
  • Zeeshan Ahmad
    • Department of GastroenterologySher-i-Kashmir Institute of Medical Sciences
Original Article

DOI: 10.1007/s12664-012-0176-2

Cite this article as:
Sodhi, J.S., Zargar, S.A., Rashid, W. et al. Indian J Gastroenterol (2012) 31: 61. doi:10.1007/s12664-012-0176-2

Abstract

Background and aim

Small bowel follow through (SBFT) and enteroclysis have low sensitivity in picking up lesions in obscure gastrointestinal bleed (OGIB). Computed tomographic enterography (CT-EG), performed with 64-slice multiphase CT system by using large volumes of ingested neutral enteric contrast material, has high spatial and temporal resolution in visualization of the small bowel wall and lumen. The role of 64-slice multiphase CT-EG in the evaluation of OGIB is still evolving, and data on this role are scarce. We evaluated the efficacy of 64-slice multiphase CT-EG using polyethylene glycol (PEG) electrolyte solution as neutral contrast in patients of OGIB.

Methods

CT-EG was performed with 64-slice multiphase CT system using large volume (2,000 mL) of PEG electrolyte solution as oral contrast in patients of OGIB.

Results

Thirty-five patients (21 men, age 41.4 [13.5] y, range 19–70 year) with OGIB underwent CT-EG; 20 patients had overt OGIB whereas 15 patients had occult OGIB. Among 15 patients with occult OGIB, 10 patients had iron deficiency anemia (IDA) with fecal occult blood test (FOBT) positive and 5 had IDA with FOBT negative. Thirty-two patients (92 %) completed the procedure successfully. The total time taken for the ingestion of 2,000 mL of PEG electrolyte solution was median 64 (range 60–78) minutes. Adequate luminal distension of small bowel was seen in 29 (90.6 %) patients for successful interpretation of radiological images. Fifteen of 32 (46.9 %) patients had positive findings on CT-EG; 12 of them underwent exploratory laparotomy. The surgical findings were in conformity with CT-EG findings in all patients, which included gastrointestinal stromal tumors (GIST; n = 6), carcinoid (1), Meckel’s diverticulum (1), small bowel adenocarcinoma (2) and jejunal vascular malformation (2).

Conclusion

64-slice multiphase CT-EG is a useful investigation in the evaluation of both occult and overt OGIB.

Keywords

Barium enteroclysisCapsule endoscopyCT-enterographySmall bowel

Copyright information

© Indian Society of Gastroenterology 2012