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Mesenteric angiography for lower gastrointestinal hemorrhage are there predictors for a positive study?

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Diseases of the Colon & Rectum

Abstract

PURPOSE: Selective mesenteric angiography is an expensive, invasive, diagnostic, and therapeutic tool for lower gastrointestinal hemorrhage. Some institutions have required a positive nuclear medicine bleeding scan before angiography. We have attempted to determine if this is a valid screening test for mesenteric angiography. Are there any other factors to predict which patients are actively bleeding and who will benefit from angiography? METHODS: All cases of mesenteric angiography for hemorrhage performed during a 12-year period were reviewed. RESULTS: A total of 131 angiograms were performed during a 12-year period with 45 patients demonstrating active bleeding; 54 patients had a bleeding scan before angiography. A positive bleeding scan did not increase the percentage of positive angiograms. A history of prior gastrointestinal bleeding, transfusions, orthostatic hypotension, or tachycardia were not predictors for a positive angiogram. DISCUSSION: This study could not identify any single useful predictor that will increase the likelihood of obtaining a positive angiogram. Nuclear medicine scans should not be used routinely as a screening test for angiography.

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Authors and Affiliations

  1. Department of Surgery, Hartford Hospital, Hartford, Connecticut

    W. P. Pennoyer M.D., P. V. Vignati M.D. & J. L. Cohen M.D.

  2. University of Connecticut Integrated Residency in General Surgery, Farmington, Connecticut

    W. P. Pennoyer M.D., P. V. Vignati M.D. & J. L. Cohen M.D.

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  1. W. P. Pennoyer M.D.
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  2. P. V. Vignati M.D.
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  3. J. L. Cohen M.D.
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Pennoyer, W.P., Vignati, P.V. & Cohen, J.L. Mesenteric angiography for lower gastrointestinal hemorrhage are there predictors for a positive study?. Dis Colon Rectum 40, 1014–1018 (1997). https://doi.org/10.1007/BF02050921

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