(Note: CTA is a separate procedure distinct from CT abdomen and pelvis without IV contrast). CT Abdomen With IV Contrast There is no significant literature supporting the use of CT abdomen with IV contrast for postsurgical or post- traumatic UGIB. (Note: CTA is a separate procedure distinct from CT abdomen with IV contrast). CT Abdomen Without and With IV Contrast There is no significant literature supporting the use of CT abdomen without and with IV contrast for postsurgical or post-traumatic UGIB. However, CT of the abdomen without and with IV contrast may be considered in patients who are suspected to have postsurgical UGIB or hemobilia [67]. In a study of postlaparoscopic sleeve gastrectomy patients presenting with UGIB, CT was able to diagnose all patients with surgical site pseudoaneurysm who were successfully treated by surgery or transcatheter arterial embolization [68]. The patients with poststent ulceration or mucosal diseases are, however, often undiagnosed by CT [68]. CT Abdomen Without IV Contrast There is no significant literature supporting the use of CT abdomen without IV contrast for postsurgical or post- traumatic UGIB. CT Enterography There is no significant literature supporting the use of CT enterography for postsurgical or post-traumatic UGIB. CT enterography requires the administration of large volumes of neutral oral contrast, which can mask GIB by dilution. Additionally, a large volume of oral contrast is often not tolerated by patients when acutely ill. However, Nonvariceal Upper Gastrointestinal Bleeding CT enterography can detect GIB because of technique parameters that can mirror CTA and is useful for patients with occult GI or suspected small bowel bleeding [5]. CTA Abdomen and Pelvis With IV Contrast Although CTA can detect arterial post-traumatic bleeding, performance with IV contrast only may not be as helpful. Without contrast images are important to identify sentinel clot and inherently hyperdense intraluminal material.
Nonvariceal Upper Gastrointestinal Bleeding. (Note: CTA is a separate procedure distinct from CT abdomen and pelvis without IV contrast). CT Abdomen With IV Contrast There is no significant literature supporting the use of CT abdomen with IV contrast for postsurgical or post- traumatic UGIB. (Note: CTA is a separate procedure distinct from CT abdomen with IV contrast). CT Abdomen Without and With IV Contrast There is no significant literature supporting the use of CT abdomen without and with IV contrast for postsurgical or post-traumatic UGIB. However, CT of the abdomen without and with IV contrast may be considered in patients who are suspected to have postsurgical UGIB or hemobilia [67]. In a study of postlaparoscopic sleeve gastrectomy patients presenting with UGIB, CT was able to diagnose all patients with surgical site pseudoaneurysm who were successfully treated by surgery or transcatheter arterial embolization [68]. The patients with poststent ulceration or mucosal diseases are, however, often undiagnosed by CT [68]. CT Abdomen Without IV Contrast There is no significant literature supporting the use of CT abdomen without IV contrast for postsurgical or post- traumatic UGIB. CT Enterography There is no significant literature supporting the use of CT enterography for postsurgical or post-traumatic UGIB. CT enterography requires the administration of large volumes of neutral oral contrast, which can mask GIB by dilution. Additionally, a large volume of oral contrast is often not tolerated by patients when acutely ill. However, Nonvariceal Upper Gastrointestinal Bleeding CT enterography can detect GIB because of technique parameters that can mirror CTA and is useful for patients with occult GI or suspected small bowel bleeding [5]. CTA Abdomen and Pelvis With IV Contrast Although CTA can detect arterial post-traumatic bleeding, performance with IV contrast only may not be as helpful. Without contrast images are important to identify sentinel clot and inherently hyperdense intraluminal material.