Traumatic gastrointestinal hemorrhage

Case contributed by Dr Ian Bickle

Presentation

This young male patient presented to A & E following an RTA and was haemodynamically unstable.

Patient Data

Gender: Male
CT

Dual Phase CT

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.

Case Discussion

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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Case information

rID: 19184
Published: 14th Aug 2012
Last edited: 25th Mar 2018
Inclusion in quiz mode: Included

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