Upper gastrointestinal bleeding other imaging findings: Difference between revisions
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==Other Imaging Findings== | ==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:<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> | 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> | *[[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> | ||
*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> | *[[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 | *[[Radionuclide imaging]] | ||
{| class="wikitable" | {| class="wikitable" | ||
! | ! | ||
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|Indications | |Indications | ||
| | | | ||
* Hemodynamically stable | * [[Hemodynamics|Hemodynamically stable]] | ||
* Endoscopy undiagnostic | * [[Endoscopy]] undiagnostic | ||
| | | | ||
* Endoscopy not feasible due to severe bleeding with hemodynamic instability | * [[Endoscopy]] not feasible due to [[Hemorrhage|severe bleeding]] with [[hemodynamic instability]] | ||
* Persistent or recurrent GI bleeding | * Persistent or recurrent GI bleeding | ||
* Non-diagnostic upper endoscopy | * Non-diagnostic upper [[endoscopy]] | ||
| | | | ||
|- | |- | ||
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* Minimally invasive | * Minimally invasive | ||
* Demonstrate neoplasms or vascular malformations | * Demonstrate [[neoplasms]] or [[Vascular malformation|vascular malformations]] | ||
* Can provide evidence of recent bleeding | * Can provide evidence of recent [[bleeding]] | ||
| | | | ||
* Diagnostic and therapeutic | * Diagnostic and therapeutic | ||
* Allows for infusion of vasoconstrictive drugs and/or embolization. | * Allows for infusion of [[Vasoconstrictive|vasoconstrictive drugs]] and/or [[embolization]]. | ||
* Does not require bowel preparation. | * Does not require bowel preparation. | ||
| | | | ||
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| | | | ||
* Lacks therapeutic capability | * Lacks therapeutic capability | ||
* Risk of contrast induced nephropathy in patients with renal impairment and contrast allergy | * Risk of [[contrast induced nephropathy]] in patients with [[renal impairment]] and contrast [[allergy]] | ||
| | | | ||
* Access-site hematoma or pseudoaneurysm | * Access-site [[hematoma]] or [[pseudoaneurysm]] | ||
* Arterial dissection | * [[Arterial dissection]] | ||
* Spasm, bowel ischemia | * [[Spasm]], [[bowel ischemia]] | ||
* Contrast-induced nephropathy or allergic reaction | * [[Contrast induced nephropathy|Contrast-induced nephropathy]] or [[allergic reaction]] | ||
| | | | ||
* Poor anatomic localization of the bleeding site | * Poor anatomic localization of the bleeding site | ||
Latest revision as of 21:32, 6 November 2017
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Upper gastrointestinal bleeding Microchapters |
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Differentiating Upper Gastrointestinal Bleeding from other Diseases |
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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 |
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| Advantages |
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| Disadvantages |
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References
- ↑ Steer ML, Silen W (1983). "Diagnostic procedures in gastrointestinal hemorrhage". N. Engl. J. Med. 309 (11): 646–50. doi:10.1056/NEJM198309153091106. PMID 6604219.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.