CT Angiography versus Red Blood Cell Scintigraphy Prior to Catheter Angiography for Lower Gastrointestinal Bleeding: Timing Is Everything

The primary diagnostic procedure in patients with lower gastrointestinal bleeding (LGIB) should be colonoscopy, but colonoscopy may fail in the presence of massive hemorrhage without colon preparation. Therefore, technetium-99m (99mTc)-labeled red blood cell (RBC) scintigraphy or computed tomography (CT) angiography should usually be performed for identification of active bleeding prior to catheter angiography (CA), except in the presence of massive bleeding. Because most cases of LGIB are intermittent in nature, the rate of bleeding should be assessed immediately, prior to RBC scan, CT angiography, or CA, to increase the yield of preprocedural imaging and CA.
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Invited Commentary Source Type: research