Traumatic gastrointestinal hemorrhage
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This young male patient presented to A & E following an RTA and was haemodynamically unstable.
Dual Phase CT
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Intraperitoneal blood and contrast extravastation.
Arterial Phase Study; pooling of contrast in the right lower abdomen adjacent to the ileocolic branch of the SMA.
Posterior to the pool of extravastated contrast is the source of the bleeding - the ileocolic artery.
Contrast pooling in the left paracolic gutter on delayed phase imaging.
Triple phase study (unenhanced, arterial and portal venous phases) recommended.
High flow rate (4ml/sec) with a high volume (150mls) of high density (350mg/ml) advised.
Needs to be performed when patient actively bleeding for accurate detection
Can detect active bleeding as low as 0.35ml/minute.
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