When diagnosing lower gastrointestinal (GI) bleeding (LGIB), what can be visualized on angiography?

Updated: Jul 26, 2019
  • Author: Burt Cagir, MD, FACS; Chief Editor: BS Anand, MD  more...
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Answer

Angiography can be used to visualize diverticula, angiodysplasia, and intestinal varices. The characteristic angiographic findings of colonic angiodysplasias are clusters of small arteries during the arterial phase of the study, accumulation of the contrast media in vascular tufts, early opacification, and persistent opacification due to the late emptying of the draining veins. If mesenteric angiography is performed at the time of active bleeding, extravasation of contrast media is visualized.

Once the bleeding point is identified, angiography offers potential treatment options, such as selective vasopressin drip and embolization. Thirteen publications reported experiences with selective mesenteric angiography. When 657 patients underwent mesenteric angiography, the percentage of positive study findings fluctuated between 27% and 86%, with an average of 45%. Because of the intermittent nature of LGIB, the number of positive study findings is significantly less with this invasive diagnostic modality.


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