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Vol. 53. Issue 5.
Pages 406-420 (September - October 2011)
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Vol. 53. Issue 5.
Pages 406-420 (September - October 2011)
Update in Radiology
DOI: 10.1016/j.rxeng.2011.03.003
Gastrointestinal bleeding: The role of radiology
Hemorragia digestiva: papel de la radiología
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S. Quiroga Gómeza,??
Corresponding author
squiroga@vhebron.net

Corresponding author.
, M. Pérez Lafuentea, M. Abu-Suboh Abadiab, J. Castell Conesac
a Servicio de Radiodiagnóstico, Hospital Universitari Vall d’Hebron, Barcelona, Spain
b Servicio de Digestivo-Endoscopia (WIDER-Barcelona), Hospital Universitari Vall d’Hebron, Barcelona, Spain
c Servicio de Medicina Nuclear, Hospital Universitari Vall d’Hebron, Barcelona, Spain
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Table 1. Main causes of gastrointestinal bleeding.
Table 2. Obscure GI bleeding according to its origin.
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Abstract

Gastrointestinal bleeding represents a diagnostic challenge both in its acute presentation, which requires the point of bleeding to be located quickly, and in its chronic presentation, which requires repeated examinations to determine its etiology. Although the diagnosis and treatment of gastrointestinal bleeding are based on endoscopic examinations, radiological studies such as computed tomography (CT) angiography for acute bleeding or CT enterography for chronic bleeding are becoming more and more common in clinical practice, even though they have not yet been included in the clinical guidelines for gastrointestinal bleeding. CT can replace angiography as the diagnostic test of choice in acute massive gastrointestinal bleeding, and CT can complement the endoscopic capsule and scintigraphy in chronic or recurrent bleeding suspected to originate in the small bowel. Angiography is currently used to complement endoscopy for the treatment of gastrointestinal bleeding.

Keywords:
Gastrointestinal bleeding
CT angiography
CT enterography
Angiography
Resumen

La hemorragia digestiva (HD) supone un problema diagnóstico tanto en su forma de presentación aguda, que requiere una rápida localización del punto de sangrado, como en la crónica, que precisa de exploraciones repetidas para determinar su etiología. El diagnóstico y tratamiento se basa en estudios endoscópicos, aunque los estudios radiológicos mediante angiografía por tomografía computarizada (TC) en la hemorragia aguda y mediante TC enterografía en la crónica son cada día más utilizados en la práctica clínica, a pesar de no estar incluidos todavía en las guías clínicas de la HD. La TC puede ser una exploración diagnóstica de primera elección en la hemorragia aguda masiva, sustituyendo a la angiografía, y una exploración diagnóstica complementaria a la cápsula endoscópica y la gammagrafía en la hemorragia crónica o recurrente cuando se sospecha un origen en el intestino delgado. La angiografía es actualmente un método terapéutico complementario a la endoscopia en el manejo de esta afección.

Palabras clave:
Hemorragia digestiva
Angiografía por TC
TC enterografía
Arteriografía

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