Gastrointestinal - Learning Modules - CTisus.com CT Scanning

Learning Modules ❯ Gastrointestinal

Small Bowel Disease: CT Findings

Wall thickening (> 3mm)
Abnormal bowel wall enhancement (increased or decreased)
Abnormal position of bowel (in hernia or malrotation)
Abnormal mesenteric fat

Active Duodenal Bleed

Bleed in Duodenum due to Ulcer

CT Enterography: GI Bleed

Angiodysplasia (number one cause)
Vascular dysplasias
Small bowel neoplasms (benign and malignant)
Meckel diverticulum

Vascular Foci in Duodenum

GIST Tumors of the Small Bowel: Clinical Presentation

bowel obstruction
intraluminal GI bleeding (occult or frank) from mucosal ulceration
intraperitoneal bleeding secondary to rupture

“Occasionally, patients may present with GI bleeding, which may be occult or take the form of frank hemorrhage with hemodynamic instability. Likewise, tumors can rupture on the external surface, causing intraperitoneal hemorrhage which can be life threatening.”
Getting the GIST: a pictorial review of the various patterns of presentation of gastrointestinal stromal tumors on imaging.
Scola D et al.
Abdom Radiol 2017 My;42(5):1350-1364.

2 cm GIST Jejunum

GIST Tumor Jejunum as the Cause of GI Bleeding

GI Bleeding in the Colon: Facts

Inflammatory disease
Ischemic colitis
Colon cancer
Radiation or chemotherapy induced complications
Trauma

Angiodysplasia and GI Bleeding

Angiodysplasia accounts for 6% of cases of lower GI bleeding.

Abnormal proliferation of venules and capillaries within submucosal layer of bowel
Degeneration of blood vessels related to aging
75% of lesions in the right colon
Colonoscopy is not sensitive for this diagnosis, identifying only 68% of cases seen on angiography
Densely opacified and dilated draining veins, early filling veins, dilated feeding artery, vascular submucosal ‘tufts’ in the wall of the colon.
Arterial phase images key, with venous phase less important

Role of Imaging Vascular Maps Beyond Axial Plane