Bleeding sigmoid diverticulum

Case contributed by Dr Chris O'Donnell

Presentation

Multiple episodes of bright red, rectal bleeding

Patient Data

Age: 70 years
Gender: Female
CT

Sigmoid divertiular disease associated with a small area of luminal contrast extravasation on the arterial phase that washes away on the delayed imaging.  This indicates active bleeding.

Annotated image

Luminal contrast extravasation on the arterial phase (arrow) that washes away on the delayed imaging, indicative of active bleeding.

Case Discussion

CT angiography for rectal bleeding is only useful if performed whilst the patient is activley bleeding. It is useful to do a 3 phase study to confirm that hyperattenuating area on the arterial phase is not just hyperdense fecal material -- a bleed should not be present on the non contrast phase and should wash away on the delayed phase.

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Case information

rID: 20291
Published: 10th Nov 2012
Last edited: 25th Dec 2019
Inclusion in quiz mode: Included

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