Department of General and Emergency Radiology, "Antonio Cardarelli" Hospital, Antonio Cardarelli St. 9, 80131 Naples, Italy.
Department of Gastroenterology and Digestive Endoscopy, "Antonio Cardarelli" Hospital, Antonio Cardarelli St. 9, 80131 Naples, Italy.
Tomography. 2022 Sep 23;8(5):2369-2402. doi: 10.3390/tomography8050198.
Gastrointestinal bleeding is a potentially life-threatening abdominal emergency that remains a common cause of hospitalisation. Although 80-85% of cases of gastrointestinal bleeding resolve spontaneously, it can result in massive haemorrhage and death. The presentation of gastrointestinal bleeding can range from asymptomatic or mildly ill patients requiring only conservative treatments to severely ill patients requiring immediate intervention. Identifying the source of the bleeding can be difficult due to the wide range of potential causes, the length of the gastrointestinal tract and the intermittent nature of the bleeding. The diagnostic and therapeutic approach is fully dependent on the nature of the bleeding and the patient's haemodynamic status. Radiologists should be aware of the appropriate uses of computed tomography angiography and other imaging modalities in patients with acute gastrointestinal bleeding, as well as the semiotics of bleeding and diagnostic pitfalls in order to appropriately diagnose and manage these patients. The learning objective of this review is to illustrate the computed tomography angiography technique, including the potential role of dual-energy computed tomography angiography, also highlighting the tips and tricks to identify the most common and uncommon features of acute gastrointestinal bleeding and its obscure form.
胃肠道出血是一种潜在的危及生命的腹部急症，仍然是导致住院的常见原因。尽管 80-85%的胃肠道出血病例会自发缓解，但它可能导致大量出血和死亡。胃肠道出血的表现范围从无症状或轻度不适的患者仅需保守治疗到需要立即干预的严重疾病患者。由于潜在原因广泛、胃肠道长度长以及出血间歇性，确定出血部位可能很困难。诊断和治疗方法完全取决于出血的性质和患者的血流动力学状态。放射科医生应该了解在急性胃肠道出血患者中使用计算机断层血管造影和其他成像方式的适当用途，以及出血的征象和诊断陷阱，以便对这些患者进行适当的诊断和治疗。本次综述的学习目标是说明计算机断层血管造影技术，包括双能计算机断层血管造影的潜在作用，还强调了识别急性胃肠道出血及其隐匿形式的最常见和不常见特征的技巧和窍门。
