Urgent computed tomography for determining the optimal timing of colonoscopy in patients with acute lower gastrointestinal bleeding

Internal Medicine
Satoko NakatsuFumio Itoh

Abstract

We evaluated the diagnostic performance of computed tomography (CT) as an initial radiologic test for assessing the optimal timing of colonoscopy in patients with acute lower gastrointestinal bleeding (LGIB) and investigated the effectiveness of contrast-enhanced (CE) CT for detecting colonic diverticular bleeding. This was a retrospective study of 1,604 consecutive patients who visited or were referred to St. Marianna University Hospital due to acute LGIB and underwent colonoscopy within three months after presentation between September 2004 and December 2012. The clinicopathological data of the subjects were obtained from their medical records. Among the 1,604 patients presenting with LGIB, 879 (55%) underwent a CT scan. Elective colonoscopy was considered in cases in which typical colonic wall thickening was observed on CT, suggesting colonic inflammation or malignancy (239 patients; 27%). The diagnoses in the elective cases included ischemic colitis (38%), infectious colitis (8%), inflammatory bowel disease (8%) and malignancy (5%). Urgent colonoscopy was performed after the CT examination in 640 cases (73%). The most common presumptive CT diagnosis was diverticulum (402/640; 63%). Of the 638 patients who underwent CE-CT, d...Continue Reading

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Citations

Sep 16, 2017·Clinical Medicine Insights. Gastroenterology·Takeshi UeharaHirosato Mashima
Dec 23, 2015·Clinical Medicine Insights. Gastroenterology·Yasumasa MatusoFumio Itoh
Oct 4, 2019·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Mitsuru KaiseKatsuhiko Iwakiri
Apr 3, 2020·Internal Medicine·Taiki AoyamaShinji Nagata
May 19, 2018·United European Gastroenterology Journal·David J WernerJohannes W Rey
Jan 16, 2019·World Journal of Gastroenterology : WJG·Tomonori AokiKazuhiko Koike
Aug 2, 2019·Clinical Journal of Gastroenterology·Yoshinori SatoFumio Itoh
Mar 19, 2021·JGH Open : an Open Access Journal of Gastroenterology and Hepatology·Yoshinori SatoFumio Itoh
Aug 12, 2020·Clinical Endoscopy·Kazuki YamamotoTakashi Ikeya
May 8, 2021·Journal of the American College of Radiology : JACR·UNKNOWN Expert Panel on Interventional RadiologyJonathan M Lorenz
May 4, 2021·Journal of the Anus, Rectum and Colon·Yoshinori SatoFumio Itoh

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