A History of Malignancy and Relevant Symptoms May Predict a Positive CT Enterography in Obscure GI Bleeds

Kristel K Leung, Usman Khan, Mei Zhang, Jeffrey D McCurdy, Paul D James
Journal of Gastroenterology and Hepatology 2019 April 9

BACKGROUND AND AIM: This study aimed to assess the clinical utility of computed tomography enterography (CTE) and identify factors associated with a diagnostic CTE for patients with obscure gastrointestinal bleeding (OGIB).

METHODS: A retrospective observational study was performed at a Canadian tertiary care centre from 2005-2015. A total of 138 patients underwent a CTE for OGIB. Univariate and multivariate logistic regression were performed to determine factors associated with a diagnostic CTE. A highly sensitive clinical rule was then developed to help identify OGIB patients for whom a CTE may be beneficial in their clinical workup.

RESULTS: A possible bleeding source was identified in 30 (22%) cases. The presence of abdominal or constitutional symptoms as well as history of colorectal cancer was significantly associated with a positive CTE in univariate and multivariate analyses (p < 0.05). A positive CTE could be predicted based on the presence of abdominal or constitutional symptoms and history of colorectal cancer with 90% sensitivity (95% CI 74-98%) in our population.

CONCLUSION: CTE identified a possible source of OGIB in 1 in 5 cases. In patients with the presence of abdominal or constitutional symptoms and a personal history of colorectal cancer, CTE may contribute to their diagnostic work-up.


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