Angiography for Acute Lower Gastrointestinal Hemorrhage: Efficacy of Cut Film Compared with Digital Subtraction Techniques

Abstract

To find out if digital subtraction angiography (DSA) has a different diagnostic power than conventional cut-film angiography in investigating acute lower gastrointestinal (GI) hemorrhage. Retrospective analysis of two cohorts of patients investigated by angiography for acute lower GI hemorrhage was performed. One group of patients treated at one center ("hospital H") underwent conventional angiography. The other patients, treated at another center ("hospital G"), were investigated exclusively by DSA. The groups were compared for demographic characteristics, etiology, and bleeding parameters. The diagnostic power of both angiographic modalities was compared and statistically analyzed. Fifty-five lower GI hemorrhages investigated by conventional cut-film angiography and 53 cases studied by DSA were included. Both study groups had statistically similar demographic and bleeding characteristics. Overall sensitivity, specificity, and positive and negative predictive values of cut-film angiography for localizing the lower GI bleeding were 62%, 73%, 86%, and 42%, whereas, for DSA, the respective values were 60%, 100%, 100%, and 24% (Z-test P values were.78,.02,.03, and.16). DSA is as sensitive as conventional cut-film angiography for localizing acute lower GI bleeding. If a lesion is found, the chance that it will be the bleeding source is higher with DSA than with conventional angiography.