Does the CT Enterography Really Lead to Better Improvement of Diagnostic Yield Than Conventional CT in Obscure Gastrointestinal Bleeding?

Abstract

Introduction: The aim of the present study was to evaluate the diagnostic performance of conventional computed tomographic (CT) and CT enterography in identifying the source of obscure gastrointestinal bleeding (OGIB) and to investigate the types of diseases that CT enterography can detect better if CT enterography shows higher diagnostic yield than conventional CT. Methods: We retrospectively included 170 patients with OGIB who received conventional CT (126 patients) or CT enterography (44 patients). The median age of the patients was 57 years, and 57.6% of patients were male. The median hospital day was 13 days. Overt bleeding was 74.7%, and occult bleeding was 25.3%. Results: Based on all performed examinations, a definitive diagnosis was made for 141 patients (82.9%): ulcer in 45 (26.4%) patients, tumor in 29 (17%), angiodysplasia in 28 (16.4%), and Crohn’s disease in 20 (11.7%). The overall diagnostic yield of conventional CT and CT enterography was 29.6% and 45.4%. (OR= 2.25; 95% CI 1.106-4.595; p=0.02). The CT enterography had better diagnostic yield than conventional CT in all etiology mentioned above, but there was no statistically significant difference. Conclusion: CT enterography showed higher diagnostic yield in patients with OGIB than conventional CT. Therefore, we need further studies with more patients to identify who will benefit from the examinations.