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Observational Study
. 2022 Apr 7;17(4):e0266622.
doi: 10.1371/journal.pone.0266622. eCollection 2022.

Usefulness of contrast-enhanced multi-detector computed tomography in identifying upper gastrointestinal bleeding: A retrospective study of patients admitted to the emergency department

Dongju Kim  1 , Ji Hoon Kim  1 , Dong Ryul Ko  1 , In Kyung Min  2 , Arom Choi  1 , Jin Ho Beom  1
Affiliations
Observational Study

Usefulness of contrast-enhanced multi-detector computed tomography in identifying upper gastrointestinal bleeding: A retrospective study of patients admitted to the emergency department

Dongju Kim et al. PLoS One. .

Abstract

Upper gastrointestinal bleeding (UGIB) is a major cause of clinical deterioration worldwide. A large number of patients with UGIB cannot be diagnosed through endoscopy, which is normally the diagnostic method of choice. Therefore, this study aimed to investigate the diagnostic value of multi-detector computed tomography (MDCT) for patients with suspected UGIB. In this retrospective observational study of 386 patients, we compared contrast-enhanced abdominopelvic MDCT to endoscopy to analyze the performance of MDCT in identifying the status, location of origin, and etiology of UGIB. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were examined. In the assessment of bleeding status, MDCT was able to accurately identify 32.9% (21.9-43.9, 95% confidence interval [CI]) of patients with active bleeding, 27.4% (18.9-35.9, 95% CI) of patients with recent bleeding, and 94.8% (91.8-97.8, 95% CI) of patients without bleeding evidence (P<0.001). MDCT showed an accuracy of 60.9%, 60.6%, and 50.9% in identifying bleeding in the esophagus, stomach, and duodenum, respectively (P = 0.4028). The accuracy in differentiating ulcerative, cancerous, and variceal bleeding was 58.3%, 65.9%, and 56.6%, respectively (P = 0.6193). MDCT has limited use as a supportive screening method to identify the presence of gastrointestinal bleeding.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study flow chart.
UGIB, upper gastrointestinal bleeding; MDCT, multi-detector computed tomography; ED, emergency department; LGI, lower gastrointestinal bleeding.
Fig 2
Fig 2. The flow diagram to use MDCT in UGIB.
UGIB, upper gastrointestinal bleeding; MDCT, multi-detector computed tomography.
See this image and copyright information in PMC

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