Optimized Multidetector Computed Tomographic Protocol for the Diagnosis of Active Obscure Gastrointestinal Bleeding: A Feasibility Study
J Comput Assist Tomogr , Volume 33, Number 5, September/October 2009
Peter Heiss, MD, Niels Zorger, MD, Okka W. Hamer, MD, Johannes Seitz, MD, Rene Muller-Wille, MD, Michael Koller, MD, Thomas Herold, MD, Jurgen Scholmerich, MD, Stefan Feuerbach, MD, and Christian E. Wrede, MD
Objective: The purpose of this feasibility study was to prospectively evaluate an optimized multidetector computed tomographic protocol for the diagnosis of active obscure gastrointestinal bleeding (OGIB).
Methods: Between October 2006 and February 2008, patients admitted for active OGIB were included in this prospective unicenter study. Water was administered orally and rectally as neutral luminal contrast material. A contrast-enhanced 16-row multidetector computed tomography (MDCT) was performed in the arterial and venous phases. Mesenteric digital subtraction angiography was carried out immediately after MDCT as standard of reference.
Results: Six patients were included in this study. Multidetector com¬puted tomography identified the bleeding site and source in 5 (83%) of the patients. Digital subtraction angiography was performed in 4 patients, and the result was positive in 1 (25%) of the patients. Multi¬detector computed tomography detected the site and source of bleeding in 2 patients whose digital subtraction angiographic result was negative.
Conclusions: The results of this feasibility study indicate that optimized MDCT is an excellent diagnostic tool for the diagnosis of active OGIB.