REGULAR CONTENT
Final ID
457
Type
Original Scientific Research-Oral or Pos
Authors
P Shukla1, A Zybulewski1, M Kolber1, E Berkowitz1, J Silberzweig1, M Hayim1
Institutions
1Mount Sinai Beth Israel, New York, NY
Purpose
To evaluate the negative predictive power of computed tomography angiography (CTA) for the identification of obscure acute gastrointestinal (GI) bleeding (GI bleeding not visualized/treated by endoscopy) on subsequent mesenteric angiography (MA) with the intention to treat.
Materials & Methods
A retrospective chart review of patients was performed who underwent mesenteric angiography for the evaluation/treatment of acute GI bleeding between November 2012 and July 2016. Patients with negative CTA examinations that proceeded to MA were identified. Negative predictive value (NPV) was calculated.
Results
20 patients (14 male, 6 female; average age: 73.1 ± 12.8 years) underwent 20 negative CTA examinations for the evaluation and treatment of GI bleeding followed by mesenteric angiography. Eighteen of 20 patients had negative subsequent MA (negative predictive value, NPV = 90%). Both false negative cases were upper GI bleed (vs 0 lower GI bleed); this difference was significant (p < 0.05).
Conclusions
The high NPV of CTA for the evaluation of GI bleeding suggests utility for excluding patients that are unlikely to benefit from MA and subsequent endovascular therapy. CTA may be considered the first line diagnostic study for the evaluation of obscure GI bleeding.
Final ID
457
Type
Original Scientific Research-Oral or Pos
Authors
P Shukla1, A Zybulewski1, M Kolber1, E Berkowitz1, J Silberzweig1, M Hayim1
Institutions
1Mount Sinai Beth Israel, New York, NY
Purpose
To evaluate the negative predictive power of computed tomography angiography (CTA) for the identification of obscure acute gastrointestinal (GI) bleeding (GI bleeding not visualized/treated by endoscopy) on subsequent mesenteric angiography (MA) with the intention to treat.
Materials & Methods
A retrospective chart review of patients was performed who underwent mesenteric angiography for the evaluation/treatment of acute GI bleeding between November 2012 and July 2016. Patients with negative CTA examinations that proceeded to MA were identified. Negative predictive value (NPV) was calculated.
Results
20 patients (14 male, 6 female; average age: 73.1 ± 12.8 years) underwent 20 negative CTA examinations for the evaluation and treatment of GI bleeding followed by mesenteric angiography. Eighteen of 20 patients had negative subsequent MA (negative predictive value, NPV = 90%). Both false negative cases were upper GI bleed (vs 0 lower GI bleed); this difference was significant (p < 0.05).
Conclusions
The high NPV of CTA for the evaluation of GI bleeding suggests utility for excluding patients that are unlikely to benefit from MA and subsequent endovascular therapy. CTA may be considered the first line diagnostic study for the evaluation of obscure GI bleeding.