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Acute Gastrointestinal Bleeding in Adults and Children: Evidence-Based Emergency Imaging

  • Rory L. O’Donohoe
  • Anne G. Carroll
  • Rory P. Kennelly
  • Dermot E. Malone
  • Ronan Ryan
  • Michael Cline
Chapter
Part of the Evidence-Based Imaging book series (Evidence-Based Imag.)

Abstract

We present a review of the current evidence regarding the role of the radiologist in the diagnosis and management of the patient presenting with acute gastrointestinal hemorrhage. Developments in multi-detector CT technology now allow the rapid performance of CT angiography, and the current evidence supports its high diagnostic performance in the setting of acute GI hemorrhage. Along with endoscopy, superselective microcoil embolization is now widely utilized as an intervention in the acutely bleeding patient, and the evidence supporting its safety and efficacy is outlined. While endoscopy remains the first-line intervention in the setting of acute upper GI bleeding, CT angiography followed by embolization may be effective for diagnosis and treatment in cases refractory to endoscopic management. In acute variceal upper GI bleeding, emergent TIPSS formation may be performed in cases not controlled at endoscopy.

Keywords

Gastrointestinal hemorrhage CT angiography Red blood cell scintigraphy Angiography Embolization Pediatrics Transjugular intrahepatic portosystemic shunt (TIPSS) Emergency imaging Evidence-based imaging 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Rory L. O’Donohoe
    • 1
  • Anne G. Carroll
    • 1
  • Rory P. Kennelly
    • 1
  • Dermot E. Malone
    • 1
  • Ronan Ryan
    • 1
  • Michael Cline
    • 2
  1. 1.Department of RadiologySt. Vincent’s University HospitalDublinIreland
  2. 2.Department of Radiology, Interventional Radiology ResidentMichigan MedicineAnn ArborUSA

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