Abstract
Purpose
To evaluate the negative predictive power of computed tomography angiography (CTA)
for the identification of obscure acute gastrointestinal (GI) bleeding (GI bleeding
not visualized/treated by endoscopy) on subsequent mesenteric angiography (MA) with
the intention to treat.
Materials and methods
A retrospective chart review of patients was performed who underwent mesenteric angiography
for the evaluation/treatment of acute GI bleeding between November 2012 and July 2016.
Patients with negative CTA examinations that proceeded to MA were identified. Negative
predictive value (NPV) was calculated.
Results
20 patients (14 male, 6 female; average age: 73.1 ± 12.8 years) underwent 20 negative CTA examinations for the evaluation and treatment of
GI bleeding followed by mesenteric angiography. Eighteen of 20 patients had negative
subsequent MA (negative predictive value, NPV = 90%). Both false negative cases were upper GI bleed (vs 0 lower GI bleed); this difference
was significant (p < 0.05).
Conclusions
The high NPV of CTA for the evaluation of GI bleeding suggests utility for excluding
patients that are unlikely to benefit from MA and subsequent endovascular therapy.
CTA may be considered for the first line diagnostic study for the evaluation of obscure
GI bleeding.
Keywords
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Article info
Publication history
Published online: March 01, 2017
Accepted:
February 24,
2017
Received in revised form:
February 3,
2017
Received:
September 15,
2016
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
