To determine the clinical utility of CT angiography (CTA) as initial diagnostic procedure in patients presenting with acute lower intestinal bleeding ( ALIB)

Figures 3 to13 Fig. 4.- Design, Duration and Ethical Criteria Fig. 5.-Candidates for inclsuion. Exclusion and remove criteria Fig. 6.- Total patients Fig. 7 and fig 8- CT Angiography Techine Fig. 9.- Main Variables Fig.10.- Image Interpretation Fig.11.- Next Emergent pocedure Fig.12.- Reference Procedure Fig.13.-Statistcal analysis

Figures 14 to 33 The identification of active bleeding is folowed by emergency therapeutic procedure (surgery, therapeutic endoscopy or angiography ) in the most cases. The presence of clots, lesions or no findings without evidence of active bleeding is usually followed by medical treatmnet and/ or observation. Scheduled surgery for definitive treatament of the cause is practiced. The graph (figure 33) shows the higt concordance betwen the diagnosis obteined by CTA and the diagnosis obteined by reference procedure

Figure 34 CTA got the right diagnosis in 62/70 ( 88,57%) cases. CTA makes unnecessary additional emergency proceudre in 35/70 (50% ) cases. CTA has been followed by emergent therapeutic procedure in 24 /70 ( 25,71%) cases. CTA has avoided emeregent diagnostic colonosocpy in 60/70 (85,7%) patients. Figure 35 When CT angiography is performed as iniitial diagnostic test in patients with ALIB, no other emeregncy diagnostic tests, in the most cases, are required, beacuse the findings allow fifferentiating patients requiring urgente treatment from those subsidiaries...

Fig. 37 Scheffel H,Pfammatter T, Wildi S, Bauefeind P, MarincekB, AlkadhiH,.Acute gastrointestinal bleeding : detection and etiology with multidetector -row CT- Eur Radiolo 200;17:1555-65 Jackle T,Stuber G, Hofman MH, Freund W, Schmitz BL, Aschoff AJ. Aute gastrointestinal bleeding:Value of MDCT.Abdom Imaging 2008;33_285_93. Dobritz M, Engels HP, Schneider A, Wieder H,Feussner H,Rumery EJ et al. Evaluation of dual phase multidetector row CT for detection of intestinal bleedingusing an experimental bowel model. Eur 2009; 239: 875-81. Yoon W,Jeong YY, Shin SS, Lin HS,Song SG, Jang NG, et...