EDITOR'S QUIZ: GI SNAPSHOT
Painful gastrointestinal haemorrhage: diagnostic value of 16 detector multislice computed tomography
Department of Radiology, Addenbrooke’s Hospital, Cambridge, UK
Correspondence to:
Correspondence to:
Dr A Groves
Radiology Department, Box 219, Addenbrooke’s Hospital, Hills Rd, Cambridge CB2 2QQ, UK; drashleygroves@hotmail.com
Keywords: tomography; spiral computed tomography
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An 84 year old women presented with a six hour history of acute abdominal pain, coffee ground vomiting, and altered blood per rectum. Her past medical history included hypertension, atrial fibrillation, and arthritis. On examination she was afebrile, normotensive, but tachycardic. There was generalised abdominal tenderness and guarding with vague localisation towards the right lower quadrant. Rectal examination revealed fresh blood mixed with stool. Blood results were unremarkable. Plain radiographs suggested a degree of small bowel obstruction with no evidence of free air. The patient underwent intravenous contrast enhanced 16 detector multislice computed tomography (fig 1
). The patient refused surgical exploration and thus was treated conservatively. She subsequently had multiple episodes of melaena and died 72 hours after admission.
[in a new window] Figure 1 Intravenous contrast enhanced 16 detector multislice computed tomography of the upper abdomen.
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What is the diagnosis?
See page 1767 for answer
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EDITOR’S QUIZ: GI SNAPSHOT
Gut 2005 54: 1767.[Extract] [Full Text] [PDF]
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