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International Journal of Colorectal Disease

, Volume 30, Issue 1, pp 57–61 | Cite as

Does the timing of an invasive mesenteric angiography following a positive CT mesenteric angiography make a difference?

  • Frederick H. Koh
  • Junwei Soong
  • Bettina Lieske
  • Wai-Kit Cheong
  • Ker-Kan TanEmail author
Original Article

Abstract

Background

Computed tomographic mesenteric angiography (CTMA) is integral in the management of patients with acute lower gastrointestinal tract bleeding (LGIB). An invasive mesenteric angiography (MA) with a view to embolize the site of bleeding is usually performed if active contrast extravasation was seen on the CTMA scans. However, the bleeding may have ceased by the time the invasive MA is performed. This study aims to identify predictors for active extravasation in invasive MA following a positive CTMA in patients with massive LGIB.

Methodology

A single-center retrospective study of all patients who underwent an invasive MA following a positive CTMA for LGIB from August 2007 to October 2013 was performed. Comparison was performed between patients who had positive and negative invasive MA after a positive CTMA.

Results

Forty-eight invasive MA scans were performed in patients with LGIB following a positive CTMA scan. Twenty-three (47.9 %) were due to diverticular disease while 20 (41.7 %) bled from the small bowel. The median delay from a positive CTMA to invasive MA was 144 (32–587) min. Of the 48 invasive MA, 25 demonstrated active extravasation. Invasive MA scans that was performed within 90 min after a positive CTMA scan were 8.56 (95 % CI 0.96–76.1, p = 0.05) times more likely to detect a positive extravasation.

Conclusion

Invasive MA should be executed promptly after a positive CTMA to increase the probability of detecting the site of bleed to allow superselective embolization.

Keywords

CT scan Bleeding Lower gastrointestinal Angiography 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Frederick H. Koh
    • 1
  • Junwei Soong
    • 1
  • Bettina Lieske
    • 1
  • Wai-Kit Cheong
    • 1
  • Ker-Kan Tan
    • 1
    Email author
  1. 1.Division of Colorectal Surgery, University Surgical ClusterNational University Hospital, National University Health System SingaporeSingaporeSingapore

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