Introduction Acute GI bleed is a medical emergency for both cliniciansand radiologists to manage with significant morbidity/mortality. Source of bleed is not always clear at presentation. Some patients have intermittent/multiple episodes of bleeding, which poses further diagnostic challenge. CT has become the initial assessment in lower GI Bleeding. OGD is still the 1stline investigation in upper GI Bleeding. CT Angiography has highsensitivity & specificity inidentifying activebleeding site, provides extraluminal information, guides treatment and catheter angiography when compared to conventional endoscopy alone. Aims and objectives To...

Retrospective review of CT Mesenteric Angiograms performed for acute GI bleed at our institution over 10 months period (2016). First 50 cases to fulfill audit criteria ie CT mesenteric angiograms for GI bleed assessed by two radiologists. Data collection included: Intended and observed protocols, CT images and reports, endoscopic assessment prior to CT, outcomes and management.

1) 7 different CT protocols identified for acute GI bleed cases.74% cases were done as per recommended protocols ie Triple phase CT (plain, arterial, portal venous phase). 2) Of the 50 cases, 14% were initially reported as positive for GI bleeding, of which 6% (3 cases) were later discovered to be false positive, on second review. 3) 2 false positivecases for learning purpose. 4)72% of cases presented as Upper GI bleed, 22% as lower GI bleed, 6% uncertain source. 5) 77% of upper GI bleed...

Conclusion and recommendations: Variable CT protocols for acute GI bleed cases used by radiologists at our institute. To standardise the practice, we proposed a new CT protocol code CTMA: Unenhanced, arterial and portal venous phase Abdomen and Pelvis without oral contrast. We recommended the usage of same protocol for every scan (i.e. both initial presentation and follow up scans). Add the CTMA protocol to local hospital guidelines and increase awareness amongst the clinicians for appropriate referral. A quarter of the patients with Upper GI bleed...

University Hospital Birmingham Local Guidelines for GI bleed. Marti M et al. Acute Lower Intestinal Bleeding: Feasibility and Diagnostic. Performance of CT Angiography, January 2012 Radiology, 262, 109-116. Laing CJ, Tobias T, Rosenblum DI, Banker WL, Tseng L, Tamarkin SW. Acute gastrointestinal bleeding: emerging role of multidetector CT angiography and review of current imaging techniques. RadioGraphics 2007;27(4):1055–1070. Fatima Regina Silva Reis, Patricia Prando Cardia, and Giuseppe D'Ippolito. Computed tomography angiography in patients with active gastrointestinal bleeding* Radiol Bras. 2015 Nov-Dec; 48(6): 381–390. Parth J Parekh,...