Role of CT enterography in obscure gastrointestinal bleeding

BackgroundObscure gastrointestinal bleeding is a radiological challenge where in almost half of the patients; the origin of the blood loss remains unexplained.AimTo highlight the use of dual phase CT enterography for the detection of obscured gastrointestinal bleed.Patient and methodsTwenty consecutive patients (11 men and 9 women) with OGIB were included in this study; their age ranged from 28 to 67 years (mean age 45.6 years). CT enterography was performed first with a non-contrast scan, followed by biphasic contrast-enhanced CT at 35 and 70 s at a rate of 4 mL/s.ResultsOn CT enterography, 12 patients (60%) were negative while 8 patients (40%) had positive findings as follows: one patient (5%) had celiac disease, 1 patient (5%) had active Crohn’s disease and another patient (5%) had ischemic bowel changes. Five patients (20%) had small bowel neoplasms as follows: (1 patient had ileal angiolipoma, 1 patient had ileal hypervascular GIST, 1 patient had duodenal GIST, 1 patient had duodenal carcinoid and 1 patient had jejunal villous adenoma).ConclusionMDCT enterography has a good diagnostic accuracy in the evaluation of patients with OGIB and can reliably indicate the source of GI bleeding and guide subsequent therapy.