Utility of CT enteroclysis for small intestinal hemorrhage

概要

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Purpose : To examine the utility and limitations of computed tomography enteroclysis (CTE) in examining clinically suspected small intestinal hemorrhage.Subjects and Methods : Subjects comprised 41 patients (16 men, 25 women) with suspected gastrointestinal bleeding based on fecal occult blood or tarry stool between April 2008 and August 2010. CTE was performed after the cause of bleeding could not be clearly identified on upper or lower gastrointestinal endoscopy. Capsule endoscopy was also performed in 25 patients and double balloon endoscopy in 13 patients. Results : CTE findings were obtained for 17 of 41 patients (41%), suggesting vascular malformation in 9 patients (22%), inflammatory bowel disease in 7 (17%), and small intestinal tumor in 1 (2%). Capsule endoscopy or double balloon endoscopy confirmed these suspicions in all except 1 patient with angiodysplasia confirmed angiographically and 1 patient with a false-positive finding of tumor. In 20 of the 24 patients showing no abnormalities on CTE, no obvious source of bleeding was found with capsule endoscopy or double balloon endoscopy.Conclusion : CTE can successfully detect a wide variety of lesions, including not only Crohn’s disease and vascular malformations, but also drug-induced small intestinal injury, small intestinal tuberculosis, and nontuberculous mycobacteriosis.