Usefulness of contrast-enhanced computed tomography in detecting the focus of gastrointestinal hemorrhage in the emergency department

Park, Gisoon; Hwang, Ji Eun

J Korean Soc Emerg Med > Volume 37(1); 2026 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2026;37(1): 20-28.

응급실에서의 위장관 출혈 병소 발견에 대한 조영증강 CT의 유용성

박기순

, 황지은

분당서울대학교병원 응급의학과

Usefulness of contrast-enhanced computed tomography in detecting the focus of gastrointestinal hemorrhage in the emergency department

Gisoon Park

, Ji Eun Hwang

Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

Correspondence

Ji Eun Hwang ,Tel: 031-787-7584, Fax: 031-787-4055, Email: trigonotis6@gmail.com,

Received: November 11, 2024; Revised: November 12, 2024 Accepted: November 12, 2024. Published online: February 28, 2026.

ABSTRACT

Objective:
This study assessed the usefulness of contrast-enhanced computed tomography (CT) in identifying the focus of gastrointestinal (GI) hemorrhage and investigated the predictive factors associated with the detection of suspected bleeding focus of CT in the emergency department (ED).
Methods:
A retrospective analysis was conducted on patients who visited the ED with GI hemorrhage symptoms and underwent contrast-enhanced CT scans from January 2016 to December 2020. The patients were divided into two groups depending on whether suspected bleeding foci were identified on CT scans. Multivariate logistic regression was performed to examine the predictive factors for detecting a suspected bleeding focus by CT.
Results:
A total of 1,554 patients were included, and suspected bleeding foci were detected on CT scans in 573 patients. The diagnostic accuracy of the CT scan was 84.1% (482 of 573). Multivariate logistic regression analysis revealed age, malignancy, hypotension event during the ED stay, etiology of varix, and tumor to be associated with the detection of suspected bleeding focus on CT scan.
Conclusion:
Contrast-enhanced CT in patients with a GI hemorrhage showed high diagnostic accuracy for evaluating bleeding foci. A CT scan is particularly useful for patients with old age, malignancy, variceal disease, and patients with hypotension events during an ED stay.

Key words: Computed tomography; Gastrointestinal hemorrhage; Hospital emergency service