Presentation
PR bleed.
Patient Data
Contrast arterial blush with delayed pooling in the lumen of the caecum.
Fusiform infrarenal abdominal aorta aneurysm with eccentric mural thrombus; no acute aortic syndromes. The remainder of the abdominal viscera is unremarkable.
Side-by-side images of the multiple phases of a GI bleed protocol confirming the contrast blush on arterial phase progressing towards the delayed images.
Patient has a confirmed angiodysplasia at the caecum.
Case Discussion
Patient with haematochezia undergoing imaging investigation in emergency department with a multi-phase CT of the abdomen and pelvis tailored for GI bleed: non-contrast, arterial phase, and delayed phase. MIP reconstructions are performed to aid the identification of source of luminal bleeding, as it can be sometimes very subtle.
This case shows a caecal bleeding without association with mass lesion or diverticular disease. Note is also made to some abnormal mural vessels which can be a subtle without the aid of MIP images. Appearances are typical for gastrointestinal angiodysplasia.
Patient has had colonoscopy months earlier confirming angiodysplasia at the caecum (photo).