Colonic intraluminal active bleeding

Case contributed by Dr Vardan Abrahamyan
Diagnosis almost certain

Presentation

Without pain PR bleeding.

Patient Data

Age: 80 years
Gender: Male
This study is a stack
Axial
non-contrast
This study is a stack
Coronal
non-contrast
This study is a stack
Axial C+
arterial phase
This study is a stack
Coronal C+
arterial phase
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Coronal C+ portal
venous phase
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Info

In the arterial phase is active extravasation of contrast into the large bowel lumen from the left side ascending colon wall. There is no colon malignancy seen.

Case Discussion

Bleeding from the lower GI tract is quite common and accounts for 20% to 30% of all patients with massive gastrointestinal bleeding. The incidence is higher in older patients and patients taking multiple drugs or selling multiple pharmacies.

CT angiography is fast, noninvasive, and widely available. CT angiography allows detection of the bleeding rate from 0.3 to 0.5 ml/min. However, it has a relatively low sensitivity (85%). Colonoscopy has been shown to correctly identify the source of lower gastrointestinal bleeding in more than 75% of patients and also allows for a therapeutic approach.

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