EURORAD ESR

Case 7140

Acute colonic bleeding shown on CT

Author(s)
Dr Peng Hui LEE
Mid Essex Hospitals
Chelmsford
CM1 7ET
United Kingdom.
 
Patient
male, 73 year(s)
 
 
  • Figure 1
    CT
     

    Non-contrast image

     

    Arterial phase image showing high attenuation in transverse colon, not present in the noncontrast image, consistent with extravasated contrast due to active bleeding.

     

    On the delayed image, contrast is still present in the bowel lumen.

     
     
     
  • Figure 2
    CT angiography
     

    Labelled image showing aorta, superior mesenteric artery, and middle colic branch.

     

    The middle colic branch is shown supplying the segment of transverse colon where contrast extravasation has occurred.

     

    The middle colic branch is shown supplying the segment of transverse colon where contrast extravasation has occurred.

     
     
     
  • Figure 3
    Angiography and embolisation
     

    Superior mesenteric arteriogram. The bleeding point is not well seen.

     

    Selective injection of middle colic branch shows contrast blush indicating bleeding point.

     

    CT angiogram for comparison.

     

    Superselective injection of feeding vessel prior to embolisation. The bleeding point is seen more clearly.

     

    Embolisation coil deployed.

     
     
     
Non-contrast image
 
Arterial phase image showing high attenuation in transverse colon, not present in the noncontrast image, consistent with extravasated contrast due to active bleeding.
 
On the delayed image, contrast is still present in the bowel lumen.
 
Labelled image showing aorta, superior mesenteric artery, and middle colic branch.
 
The middle colic branch is shown supplying the segment of transverse colon where contrast extravasation has occurred.
 
The middle colic branch is shown supplying the segment of transverse colon where contrast extravasation has occurred.
 
Superior mesenteric arteriogram. The bleeding point is not well seen.
 
Selective injection of middle colic branch shows contrast blush indicating bleeding point.
 
CT angiogram for comparison.
 
Superselective injection of feeding vessel prior to embolisation. The bleeding point is seen more clearly.
 
Embolisation coil deployed.
 
 
 
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