title: Is urgent CT angiography necessary in cases of acute lower gastrointestinal bleeding?
abstract: Acute lower gastrointestinal bleeding usually presents as hematochezia, rectal bleeding or melena and represents 1-2% of the medical appointments in the Emergency Services. Mortality reaches the 30-40% and it is highly related with the severity and associated comorbidity. Most clinical practice guidelines include colonoscopy at some point in the diagnostic and therapeutic process (urgent for severe cases and ambulatory for mild ones) and look for predictors of severity. In the last years, there have been numerous studies where is clear the relevance and complementarity of advanced diagnostic imaging techniques, gradually incorporated as an alternative or second step in severe cases. Therefore, we have made a review of current scientific evidence to establish a clinical prediction rule for optimal indication of CT angiography in these patients. However, future studies providing greater robustness and level of evidence are necessary.
authors.affiliation: Sección de Radiología, Hospital Universitario La Paz, Madrid, España. Electronic address: alfonsomd88@gmail.com.
authors.forename: A Martín
authors.initials: AM
authors.lastname: Díaz
authors.affiliation: Sección de Radiología, Hospital Universitario La Paz, Madrid, España.
authors.forename: L Fernández
authors.initials: LF
authors.lastname: Rodríguez
authors.affiliation: Sección de Radiología, Hospital Universitario La Paz, Madrid, España.
authors.forename: M Martí
authors.initials: MM
authors.lastname: de Gracia
mesh_terms: D000208:Acute Disease; D000072226:Computed Tomography Angiography; D004630:Emergencies; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging*; D006801:Humans
keywords: Angiografía; Angiography; Clinical prediction rule; Gastrointestinal hemorrhage; Hemorragia gastrointestinal; Multidetector computed tomography; Regla de predicción clínica; Tomografía computarizada multidetector