[Clinical Efficacy of Dynamic Contrast-enhanced Multidetector-row Computed Tomography in Patients with Obscure Gastrointestinal Bleeding].
OBJECTIVE
Obscure gastrointestinal bleeding (OGIB) accounts for 5% of all gastrointestinal (GI) bleeding cases. Dynamic contrast-enhanced multidetector-row CT (DCE-MDCT) is not generally recommended in OGIB patients due to its low sensitivity. However, it can be used to quickly and simply diagnose OGIB according to some guidelines. The aim of this study was to evaluate the clinical efficacy of DCE-MDCT in OGIB patients.


METHODS
We retrospectively analyzed the medical records of 362 patients who underwent DCE-MDCT between March 2009 and January 2014. A total of 45 patients diagnosed with OGIB were included in this study. Their baseline characteristics and treatment procedure were analyzed retrospectively. The positive rates of DCE-MDCT for the detection of bleeding and associated factors were assessed.


RESULTS
The mean age of the patients was 59 years, and males represented 51.1%. Melena was the most common symptom (44.4%). Positive rate of DCE-MDCT findings was 20.0% (9/45). Among these patients, intraluminal contrast extravasation was found in 5 patients (55.6%) and intraluminal hematoma or mass lesions were found in 2 patients each (22.2%). Thirty nine patients (86.7%) underwent conservative management, and 6 patients (13.3%) underwent specific treatment, such as endoscopic treatment, embolization, or surgery. Patients who showed positivity in DCE-MDCT more frequently received specific treatment compared with those who were negative (44.4% vs. 5.6%, p=0.010).


CONCLUSIONS
Although DCE-MDCT showed a low positive rate (20.0%), positive findings of DCE-MDCT could lead to specific treatment. Positive DCE-MDCT findings play a useful role in the management of patients with OGIB.
Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
Jaemin
J
Jo
Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
Hyun Joo
HJ
Song
Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
Sun Jin
SJ
Boo
Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
Soo Young
SY
Na
Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
Heung Up
HU
Kim
Department of Radiology, Jeju National University School of Medicine, Jeju, Korea.
Seung Hyoung
SH
Kim
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008551:Melena / Q000209:etiology; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D012008:Recurrence; D012189:Retrospective Studies
Gastrointestinal hemorrhage; Multidetector computed tomography