Presentation
Multiple episodes of bright red, rectal bleeding
Patient Data
Age: 70 years
Gender: Female
From the case:
Bleeding sigmoid diverticulum
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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.
From the case:
Bleeding sigmoid diverticulum
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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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