EURORAD ESR

Case 14410

Massive lower gastrointestinal bleeding from caecal varices diagnosed by using CT angiography

Author(s)
Kristiina Langemets, Pilvi Ilves

Tartu University Hospital, Radiology Clinic, L. Puusepa 1A 50406 Tartu, Estonia Email:kristiina.langemets@gmail.com
 
Patient
male, 45 year(s)
 
 
  • Figure 1
    Unenhanced CT of the abdomen

    Unenhanced CT of the abdomen (axial view): Distended large bowel filled with high-attenuating fluid. Additionally small amount of ascites.

     
    Area of Interest: Abdomen; Colon; Emergency; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;
     
     
  • Figure 2
    CT-angiography of the abdomen

    CT-angiography of the abdomen, arterial phase (axial view): Distended large bowel filled with high-attenuating fluid, no contrast extravasation is seen. Bowel contents about 35 HU.

     
    Area of Interest: Abdomen; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;
     
     
  • Figure 3
    CT-angiography of the abdomen
     

    CT-angiography of the abdomen, venous phase (axial view): Network of venous varices around the caecum (white arrows) and large venous collateral communication with the portal vein (black arrow; communication not shown)

     
    Area of Interest: Abdomen; Colon; Emergency; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;

    CT-angiography of the abdomen,venous phase (axial view): Extravasated contrast material is seen in the caecum lumen. Bowel contents enhance - 75 HU.

     
    Area of Interest: Emergency; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;
     
     
  • Figure 4
    CT-angiography of the abdomen, venous phase. MIP reconstruction

    CT-angiography of the abdomen,venous phase, coronary MIP reconstruction showing the communication of caecal varices with the portal vein.

     
    Area of Interest: Emergency; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;
     
     
  • Figure 5
    CT-angiography of the abdomen, venous phase. MPR reconstruction

    Network of venous varices around the caecum and large venous collateral communication with the portal vein.

     
    Area of Interest: Emergency; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;
     
     
Unenhanced CT of the abdomen (axial view): Distended large bowel filled with high-attenuating fluid. Additionally small amount of ascites.
 
CT-angiography of the abdomen, arterial phase (axial view): Distended large bowel filled with high-attenuating fluid, no contrast extravasation is seen. Bowel contents about 35 HU.
 
CT-angiography of the abdomen, venous phase (axial view): Network of venous varices around the caecum (white arrows) and large venous collateral communication with the portal vein (black arrow; communication not shown)
 
CT-angiography of the abdomen,venous phase (axial view): Extravasated contrast material is seen in the caecum lumen. Bowel contents enhance - 75 HU.
 
CT-angiography of the abdomen,venous phase, coronary MIP reconstruction showing the communication of caecal varices with the portal vein.
 
Network of venous varices around the caecum and large venous collateral communication with the portal vein.
 
 
 
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