Abstract No. 325 - CTA findings and therapy for gastrointestinal (GI) bleeding: a pictorial review

Abstract

Learning ObjectivesTo review the spectrum of gastrointestinal (GI) bleed CT-angiography (CTA) imaging findings and describe how these findings influence treatment decisions. To review the indications and contraindications for CTAevaluation of GI bleeding. To illustrate how salient findings change management and therapeutic choice.BackgroundGastrointestinal bleeding remains a common and life-threatening medical emergency, particularly in the at-risk patient on anticoagulant medication, with bleeding diathesis, or with liver disease. At many centers, the management of occult gastrointestinal bleeding often requires on-call interventional radiologist involvement in bleed localization. The interventionalist must be able to expediently review imaging findings, most commonly using CTA, to decide whether to pursue intervention.Clinical Findings/Procedure DetailsFrom our database and from a review of literature, we will present: 1. The spectrum of CTAfindings found in patients with gastrointestinal bleeding. 2. The limitations of CT imaging and appropriate uses of radionuclide imaging or angiogaphy. 3. Therapeutic considerations as they relate to salient CT findings.Conclusion and/or Teaching PointsAfter reviewing this exhibit, the interventional radiologist should be capable of: 1). Understanding the spectrum of pertinent CTAfindings in the bleeding patient. 2). Understand the limitations of CT in diagnosing acute bleeds. 3). Appreciate when angiography or radionuclide imaging should be pursued. 4. Discuss cases where CT imaging findings have altered management plans or therapy choice. Learning ObjectivesTo review the spectrum of gastrointestinal (GI) bleed CT-angiography (CTA) imaging findings and describe how these findings influence treatment decisions. To review the indications and contraindications for CTAevaluation of GI bleeding. To illustrate how salient findings change management and therapeutic choice. To review the spectrum of gastrointestinal (GI) bleed CT-angiography (CTA) imaging findings and describe how these findings influence treatment decisions. To review the indications and contraindications for CTAevaluation of GI bleeding. To illustrate how salient findings change management and therapeutic choice. BackgroundGastrointestinal bleeding remains a common and life-threatening medical emergency, particularly in the at-risk patient on anticoagulant medication, with bleeding diathesis, or with liver disease. At many centers, the management of occult gastrointestinal bleeding often requires on-call interventional radiologist involvement in bleed localization. The interventionalist must be able to expediently review imaging findings, most commonly using CTA, to decide whether to pursue intervention. Gastrointestinal bleeding remains a common and life-threatening medical emergency, particularly in the at-risk patient on anticoagulant medication, with bleeding diathesis, or with liver disease. At many centers, the management of occult gastrointestinal bleeding often requires on-call interventional radiologist involvement in bleed localization. The interventionalist must be able to expediently review imaging findings, most commonly using CTA, to decide whether to pursue intervention. Clinical Findings/Procedure DetailsFrom our database and from a review of literature, we will present: 1. The spectrum of CTAfindings found in patients with gastrointestinal bleeding. 2. The limitations of CT imaging and appropriate uses of radionuclide imaging or angiogaphy. 3. Therapeutic considerations as they relate to salient CT findings. From our database and from a review of literature, we will present: 1. The spectrum of CTAfindings found in patients with gastrointestinal bleeding. 2. The limitations of CT imaging and appropriate uses of radionuclide imaging or angiogaphy. 3. Therapeutic considerations as they relate to salient CT findings. Conclusion and/or Teaching PointsAfter reviewing this exhibit, the interventional radiologist should be capable of: 1). Understanding the spectrum of pertinent CTAfindings in the bleeding patient. 2). Understand the limitations of CT in diagnosing acute bleeds. 3). Appreciate when angiography or radionuclide imaging should be pursued. 4. Discuss cases where CT imaging findings have altered management plans or therapy choice. After reviewing this exhibit, the interventional radiologist should be capable of: 1). Understanding the spectrum of pertinent CTAfindings in the bleeding patient. 2). Understand the limitations of CT in diagnosing acute bleeds. 3). Appreciate when angiography or radionuclide imaging should be pursued. 4. Discuss cases where CT imaging findings have altered management plans or therapy choice.