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Prospective Study Comparing Multi-Detector Row CT and Endoscopy in Acute Gastrointestinal Bleeding

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Abstract

Background

Upper and lower acute gastrointestinal bleeding (AGIB) is associated with high rates of mortality and morbidity. The latest computerized tomography (CT) imaging techniques play an important role in the treatment of this pathology.

Methods

Twenty-nine patients with severe AGIB (11 upper, 18 lower), all hemodynamically stable, underwent endoscopy followed by a multi-detector row CT (MDCT) scan. Endoscopic and MDCT accuracy for the anatomical localization and etiology of AGIB was assessed, the diagnosis being considered correct when the two procedures were concordant or when the diagnosis was confirmed by angiographic, surgical, or post-mortem findings.

Results

The sensitivity in identifying the site and etiology of bleeding was, respectively, 100% and 90.9% for the MDCT scan, compared with 72.7% and 54.5% for endoscopy in upper AGIB, and 100% and 88.2% for the MDCT scan, compared with 52.9% and 52.9% for endoscopy, in lower AGIB.

Conclusions

Considering the advantages of MDCT over endoscopy, we propose a new diagnostic algorithm for AGIB.

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Authors and Affiliations

  1. Department of Surgery “P.Stefanini”, “Policlinico Umberto I” Hospital, “Sapienza” University of Rome, Viale del Policlinico, 155 00161, Rome, Italy

    Fabrizio M. Frattaroli, Domenico Spoletini, Aldo Nunziale & Giuseppe Pappalardo

  2. Radiological Unit, Department of Emergency Medicine, “Policlinico Umberto I” Hospital, “Sapienza” University of Rome, Viale del Policlinico, 155 00161, Rome, Italy

    Emanuele Casciani, Elisabetta Polettini, Luca Bertini & Gianfranco Gualdi

  3. Department of Experimental Medicine, “Policlinico Umberto I” Hospital, “Sapienza” University of Rome, Viale del Policlinico, 155 00161, Rome, Italy

    Annarita Vestri

  4. Via Pietro Paolo Vergerio, 12 00135, Rome, Italy

    Fabrizio M. Frattaroli

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  1. Fabrizio M. Frattaroli
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  2. Emanuele Casciani
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  3. Domenico Spoletini
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  4. Elisabetta Polettini
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  6. Luca Bertini
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  7. Annarita Vestri
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  8. Gianfranco Gualdi
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  9. Giuseppe Pappalardo
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Correspondence to Fabrizio M. Frattaroli.

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Frattaroli, F.M., Casciani, E., Spoletini, D. et al. Prospective Study Comparing Multi-Detector Row CT and Endoscopy in Acute Gastrointestinal Bleeding. World J Surg 33, 2209–2217 (2009). https://doi.org/10.1007/s00268-009-0156-6

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  • DOI: https://doi.org/10.1007/s00268-009-0156-6

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