PulmCrit (EMCrit) - June 21, 2015 - By Josh Farkas
Jacovides CL et al. Arteriography for lower gastrointestinal hemorrhage: Role of preceding abdominal computed tomographic angiogram in diagnosis and localization. JAMA Surgery May 2015.
"This was an observational trial of the effect of implementing a protocol for lower GI hemorrhage involving prompt CT angiography for all urgent and emergent cases (below). The protocol was implemented in 2009. Data was extracted from all patients undergoing invasive angiography for four years before and after protocol implementation.
Overall this study supports a CT angiography-based strategy as a legitimate and evidence-based approach to lower GI bleeding. With ongoing improvements in multi-detector helical CT scanners and safer intravenous contrast, we expect that the pendulum will continue to swing towards CT angiography as an immediate and definitive approach to evaluate a patient with critical lower GI hemorrhage."
http://emcrit.org/pulmcrit/ct-angiography-for-lower-gi-bleed-the-university-of-pennsylvania-experience/