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MDCT of Acute Lower Gastrointestinal Bleeding

Khimseng Tew1, Roger P. Davies1,2, Changez K. Jadun1,3 and Jacqueline Kew1

1 Department of Radiology, North Western Adelaide Health Service, The Queen Elizabeth Hospital Campus, Adelaide, South Australia 5011, Australia.
2 Present address: Department of Imaging, Mid Western Area Health Service, OBH, Dalton St., Orange, New South Wales 2800, Australia.
3 Present address: Department of Neuroradiology, Vancouver General Hospital, Vancouver, BC V5Z1P4, Canada.



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Fig. 1A. 83-year-old woman who presented with hematochezia. Contrast-enhanced arterial phase axial MDCT scan shows intraluminal contrast material extravasation (arrow) in ileum. Normal mucosal enhancement (arrowheads) is also shown.

 


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Fig. 1B. 83-year-old woman who presented with hematochezia. Selective arteriogram of ileocecal branches shows acute contrast material extravasation (arrow) corresponding to hemorrhage shown on MDCT scan (A).

 


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Fig. 2. In 69-year-old man who presented with hematochezia due to bleeding diverticulum, IV contrast–enhanced arterial phase axial MDCT scan shows intraluminal contrast material extravasation (arrows) in hepatic flexure.

 


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Fig. 3. MDCT scan obtained in 71-year-old woman with hematochezia from bleeding sigmoid diverticulum shows extravasated contrast material (arrow) flowing into lumen.

 


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Fig. 4. Unenhanced MDCT scan obtained in 64-year-old man shows hyperdense suture material (arrows) as possible mimic of contrast material extravasation. Continuity and homogeneity of density allow differentiation of bleeding from contrast material extravasation.

 

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