Neil Sengupta, David M Kastenberg, David H Bruining, Melissa Latorre, Jonathan A Leighton, Olga R Brook, Michael L Wells, Flavius F Guglielmo, Haresh V Naringrekar, Michael S Gee, Jorge A Soto, Seong Ho Park, Don C Yoo, Vijay Ramalingam, Alvaro Huete, Ashish Khandelwal, Avneesh Gupta, Brian C Allen, Mark A Anderson, Bari R Dane, Farnoosh Sokhandon, David J Grand, Justin R Tse, Jeff L Fidler
Radiology . 2024 Mar;310(3):e232298. doi: 10.1148/radiol.232298.
Gastrointestinal (GI) bleeding is the most common GI diagnosis leading to hospitalization within the United States. Prompt diagnosis and treatment of GI bleeding is critical to improving patient outcomes and reducing high health care utilization and costs. Radiologic techniques including CT angiography, catheter angiography, CT enterography, MR enterography, nuclear medicine red blood cell scan, and technetium-99m pertechnetate scintigraphy (Meckel scan) are frequently used to evaluate patients with GI bleeding and are complementary to GI endoscopy. However, multiple management guidelines exist, which differ in the recommended utilization of these radiologic examinations. This variability can lead to confusion as to how these tests should be used in the evaluation of GI bleeding. In this document, a panel of experts from the American College of Gastroenterology and Society of Abdominal Radiology provide a review of the radiologic examinations used to evaluate for GI bleeding including nomenclature, technique, performance, advantages, and limitations. A comparison of advantages and limitations relative to endoscopic examinations is also included. Finally, consensus statements and recommendations on technical parameters and utilization of radiologic techniques for GI bleeding are provided.