Upper gastrointestinal bleeding other imaging findings: Difference between revisions

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__NOTOC__
__NOTOC__
{{Upper gastrointestinal bleeding}}
{{Upper gastrointestinal bleeding}}
 
{{CMG}} ; {{AE}} {{ADG}}
{{CMG}}; {{AE}}  
 
==Overview==
==Overview==
There are no other imaging findings associated with [disease name].
In cases where the source of bleeding is unidentified after upper endoscopy, the utilization of subsequent diagnostic modalities depends upon the hemodynamic stability of the patient. Other imaging studies include CT angiography, catheter angiography, radionuclide imaging.


OR
==Other Imaging Findings==
In cases where the source of bleeding is unidentified after upper [[endoscopy]], the utilization of subsequent diagnostic modalities depends upon the [[Hemodynamics|hemodynamic stability]] of the patient. Other diagnostic studies include:<ref name="pmid6604219">{{cite journal |vauthors=Steer ML, Silen W |title=Diagnostic procedures in gastrointestinal hemorrhage |journal=N. Engl. J. Med. |volume=309 |issue=11 |pages=646–50 |year=1983 |pmid=6604219 |doi=10.1056/NEJM198309153091106 |url=}}</ref><ref name="pmid3094466">{{cite journal |vauthors=Browder W, Cerise EJ, Litwin MS |title=Impact of emergency angiography in massive lower gastrointestinal bleeding |journal=Ann. Surg. |volume=204 |issue=5 |pages=530–6 |year=1986 |pmid=3094466 |pmc=1251335 |doi= |url=}}</ref><ref name="pmid2334015">{{cite journal |vauthors=Hunter JM, Pezim ME |title=Limited value of technetium 99m-labeled red cell scintigraphy in localization of lower gastrointestinal bleeding |journal=Am. J. Surg. |volume=159 |issue=5 |pages=504–6 |year=1990 |pmid=2334015 |doi= |url=}}</ref><ref name="pmid26054245">{{cite journal |vauthors=Loffroy R, Favelier S, Pottecher P, Estivalet L, Genson PY, Gehin S, Cercueil JP, Krausé D |title=Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding: Indications, techniques and outcomes |journal=Diagn Interv Imaging |volume=96 |issue=7-8 |pages=731–44 |year=2015 |pmid=26054245 |doi=10.1016/j.diii.2015.05.002 |url=}}</ref>
*[[CT angiography]]<ref name="pmid20232200">{{cite journal |vauthors=Loffroy R, Rao P, Ota S, De Lin M, Kwak BK, Geschwind JF |title=Embolization of acute nonvariceal upper gastrointestinal hemorrhage resistant to endoscopic treatment: results and predictors of recurrent bleeding |journal=Cardiovasc Intervent Radiol |volume=33 |issue=6 |pages=1088–100 |year=2010 |pmid=20232200 |doi=10.1007/s00270-010-9829-7 |url=}}</ref>
*[[Angiography|Catheter angiography]]<ref name="pmid22468082">{{cite journal |vauthors=Walker TG, Salazar GM, Waltman AC |title=Angiographic evaluation and management of acute gastrointestinal hemorrhage |journal=World J. Gastroenterol. |volume=18 |issue=11 |pages=1191–201 |year=2012 |pmid=22468082 |pmc=3309908 |doi=10.3748/wjg.v18.i11.1191 |url=}}</ref><ref name="pmid26397323">{{cite journal |vauthors=Zurkiya O, Walker TG |title=Angiographic Evaluation and Management of Nonvariceal Gastrointestinal Hemorrhage |journal=AJR Am J Roentgenol |volume=205 |issue=4 |pages=753–63 |year=2015 |pmid=26397323 |doi=10.2214/AJR.15.14803 |url=}}</ref>
*[[Radionuclide imaging]]
{| class="wikitable"
!
!CT angiography
!Catheter angiography
!Radionuclide imaging
|-
|Bleeding at rates
detection
|At least 0.5 mL/min
|0.5 to 1.5 mL/min
|0.1 mL/min
|-
|Indications
|
* [[Hemodynamics|Hemodynamically stable]]
* [[Endoscopy]] undiagnostic
|
* [[Endoscopy]] not feasible due to [[Hemorrhage|severe bleeding]] with [[hemodynamic instability]]


[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
* Persistent or recurrent GI bleeding
* Non-diagnostic upper [[endoscopy]]  
|
|-
|Advantages
|
* Minimally invasive 


==Other Imaging Findings==
* Demonstrate [[neoplasms]] or [[Vascular malformation|vascular malformations]]
*There are no other imaging findings associated with [disease name].


*[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include:
* Can provide evidence of recent [[bleeding]]
**[Finding 1]
|
**[Finding 2]
* Diagnostic and therapeutic
**[Finding 3]
* Allows for infusion of [[Vasoconstrictive|vasoconstrictive drugs]] and/or [[embolization]].
* Does not require bowel preparation. 
|
* Most sensitive imaging modality for GI bleeding
* More commonly utilized for investigation of patients with obscure, intermittent bleeding
|-
|Disadvantages
|
* Lacks therapeutic capability
* Risk of [[contrast induced nephropathy]] in patients with [[renal impairment]] and contrast [[allergy]]
|
* Access-site [[hematoma]] or [[pseudoaneurysm]]
* [[Arterial dissection]]  
* [[Spasm]], [[bowel ischemia]]
* [[Contrast induced nephropathy|Contrast-induced nephropathy]] or [[allergic reaction]]
|
* Poor anatomic localization of the bleeding site
* Unable to diagnose the pathological cause of GI bleeding
|}


==References==
==References==

Latest revision as of 21:32, 6 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

In cases where the source of bleeding is unidentified after upper endoscopy, the utilization of subsequent diagnostic modalities depends upon the hemodynamic stability of the patient. Other imaging studies include CT angiography, catheter angiography, radionuclide imaging.

Other Imaging Findings

In cases where the source of bleeding is unidentified after upper endoscopy, the utilization of subsequent diagnostic modalities depends upon the hemodynamic stability of the patient. Other diagnostic studies include:[1][2][3][4]

CT angiography Catheter angiography Radionuclide imaging
Bleeding at rates

detection

At least 0.5 mL/min 0.5 to 1.5 mL/min 0.1 mL/min
Indications
  • Persistent or recurrent GI bleeding
  • Non-diagnostic upper endoscopy
Advantages
  • Minimally invasive 
  • Most sensitive imaging modality for GI bleeding
  • More commonly utilized for investigation of patients with obscure, intermittent bleeding
Disadvantages
  • Poor anatomic localization of the bleeding site
  • Unable to diagnose the pathological cause of GI bleeding

References

  1. ↑ Steer ML, Silen W (1983). "Diagnostic procedures in gastrointestinal hemorrhage". N. Engl. J. Med. 309 (11): 646–50. doi:10.1056/NEJM198309153091106. PMID 6604219.
  2. ↑ Browder W, Cerise EJ, Litwin MS (1986). "Impact of emergency angiography in massive lower gastrointestinal bleeding". Ann. Surg. 204 (5): 530–6. PMC 1251335. PMID 3094466.
  3. ↑ Hunter JM, Pezim ME (1990). "Limited value of technetium 99m-labeled red cell scintigraphy in localization of lower gastrointestinal bleeding". Am. J. Surg. 159 (5): 504–6. PMID 2334015.
  4. ↑ Loffroy R, Favelier S, Pottecher P, Estivalet L, Genson PY, Gehin S, Cercueil JP, Krausé D (2015). "Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding: Indications, techniques and outcomes". Diagn Interv Imaging. 96 (7–8): 731–44. doi:10.1016/j.diii.2015.05.002. PMID 26054245.
  5. ↑ Loffroy R, Rao P, Ota S, De Lin M, Kwak BK, Geschwind JF (2010). "Embolization of acute nonvariceal upper gastrointestinal hemorrhage resistant to endoscopic treatment: results and predictors of recurrent bleeding". Cardiovasc Intervent Radiol. 33 (6): 1088–100. doi:10.1007/s00270-010-9829-7. PMID 20232200.
  6. ↑ Walker TG, Salazar GM, Waltman AC (2012). "Angiographic evaluation and management of acute gastrointestinal hemorrhage". World J. Gastroenterol. 18 (11): 1191–201. doi:10.3748/wjg.v18.i11.1191. PMC 3309908. PMID 22468082.
  7. ↑ Zurkiya O, Walker TG (2015). "Angiographic Evaluation and Management of Nonvariceal Gastrointestinal Hemorrhage". AJR Am J Roentgenol. 205 (4): 753–63. doi:10.2214/AJR.15.14803. PMID 26397323.

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