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Gastrointestinal hemorrhage: evaluation with MDCT

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Abstract

Gastrointestinal (GI) bleeding is a common medical problem, with high associated morbidity and mortality. The clinical presentation of gastrointestinal hemorrhage varies with the location of the bleeding source, the intensity of the bleed, and the presence of comorbidities that affect the ability to tolerate blood loss. Conventional endoscopic examinations are usually the initial diagnostic tests in patients presenting with overt gastrointestinal hemorrhage. However, implementation of upper tract endoscopy and colonoscopy in the emergency setting can be challenging due to inconsistent availability of the service and difficulties in achieving adequate colonic cleansing in emergent situations. Thus, imaging tests are often relied upon to establish the location and the cause of bleeding, either for initial diagnosis or after non-revealing upper and lower tract endoscopies (“obscure” bleeding). This article discusses the imaging evaluation of patients with gastrointestinal bleeding and reviews the imaging appearance of the most common causes, taking into account the two most relevant clinical presentations: overt bleeding and obscure bleeding.

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Authors and Affiliations

  1. Boston University and Boston Medical Center, 820 Harrison Avenue, FGH3, Boston, MA, 02118, USA

    Jorge A. Soto

  2. Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea

    Seong Ho Park

  3. Department of Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA

    Joel G. Fletcher & Jeff L. Fidler

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  1. Jorge A. Soto
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  2. Seong Ho Park
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  4. Jeff L. Fidler
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Correspondence to Jorge A. Soto.

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Soto, J.A., Park, S.H., Fletcher, J.G. et al. Gastrointestinal hemorrhage: evaluation with MDCT. Abdom Imaging 40, 993–1009 (2015). https://doi.org/10.1007/s00261-015-0365-4

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