Abstract
Lower gastro-intestinal bleeding (LGIB) is defined as a bleeding site localised in the colon or anorectum. (1) In the past, the diagnosis of LGIB has been a serious challenge for the radiology department because of its possible intermittent character, making it difficult to pinpoint the bleeding site. Patients with a LGIB will typically have undergone a long diagnostic work-up before they end up on the interventional radiology department. The development of multi-detector computed tomography (CT) has made radiological diagnosis of LGIB easier. CT is not only able to localize the active bleeding site but may also demonstrate the vascular anatomy and the underlying cause, hereby directing further management and guiding therapeutic interventions, as will be illustrated in both of our cases.
Highlights
(1) In the past, the diagnosis of Lower gastro-intestinal bleeding (LGIB) has been a serious challenge for the radiology department because of its possible intermittent character, making it difficult to pinpoint the bleeding site
Lower gastro-intestinal bleeding (LGIB) is defined as a bleeding site localised in the colon or anorectum (1)
Frattaroli et al compared the diagnostic accuracy of endoscopy and MDCT
Summary
— Coronal reconstructed maximum intensity projections of CTA images in arterial phase demonstrate the intraluminal contrast agent (arrow) due to bleeding from the medial colic artery, originating from the superior mesenteric artery. During selective angiography 10 mL of contrast agent was administered during each run (Hexabrix©, Ioxaglate 320 mg/ml, Guerbet, Roissy Charles de Gaule, France) at about 2 mL/s for both cases. CA image after injection of contrast in the inferior mesenterior artery without identifiable bleeding site. B. Coronal CTA image in the arterial phase demonstrating the rectosigmoidal bleeding (arrow). C. Selective catheterisation of a sigmoid artery with injection of contrast material did not show the bleeding site. After the localisation of the bleeding site multiplanar reconstructions and maximum intensity projections were
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