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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  ;  Ji Hoon Kim  ;  Dong Ryul Ko  ;  In Kyung Min  ;  Arom Choi  ;  Jin Ho Beom 
 PLOS ONE, Vol.17(4) : e0266622, 2022-04 
Journal Title
Issue Date
Emergency Service, Hospital ; Esophageal and Gastric Varices* / complications ; Gastrointestinal Hemorrhage / etiology ; Humans ; Multidetector Computed Tomography ; Retrospective Studies
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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1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Ko, Dong Ryul(고동률) ORCID logo https://orcid.org/0000-0002-3098-2784
Kim, Ji Hoon(김지훈) ORCID logo https://orcid.org/0000-0002-0070-9568
Beom, Jin Ho(범진호) ORCID logo https://orcid.org/0000-0002-2805-257X
Choi, Arom(최아롬)
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