{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T22:36:13Z","timestamp":1782599773272,"version":"3.54.5"},"reference-count":29,"publisher":"Royal College of Surgeons of England","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p> The clinical presentation of lower gastrointestinal bleeding (LGIB) is variable in severity, cause and potential investigations. The British Society of Gastroenterology recently published LGIB guidelines, recommending CT angiography (CT-A) for haemodynamically unstable patients, defined by shock index (SI) greater than 1. The aim of this study was to assess the use and role of CT-A in diagnosing LGIB, by assessing the pickup rate of active LGIB defined by contrast extravasation or \u2018blush\u2019 and to determine any association between positive CT-A with various patient and clinical characteristics. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> A retrospective analysis was carried out of 4 years of LGIB admissions. Demographics, inpatient observations and use of blood products were acquired. Vital signs nearest the time of CT-A plus abnormal vital signs preceding imaging were used to calculate SI, Age SI, National Early Warning Score 2 (NEWS2) and Standardised Early Warning Score (SEWS). A consultant gastrointestinal radiologist further reviewed all consultant-reported scans. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> In total, 930 patients were admitted with LGIB. Median age was 71 years and 51% were male; 179 (19.2%) patients received red blood cell transfusion and 93 patients (10%) underwent CT-A, who were older and were likely to be hypotensive and receive red cell transfusions. Following exclusions, 92 CT-As were included in the analysis. Nine (9.8%) were positive. Univariate analysis showed no association between positive CT-A and any scoring system. A multivariate analysis, including age and gender, showed association between both NEWS2 and SEWS scores with positive CT-A. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> In our analysis of the typical LGIB population, CT-A has shown relatively low pick up rate of active bleeding. CT-A clearly has a role in the investigation of LGIB, but selection remains challenging. <\/jats:p><\/jats:sec>","DOI":"10.1308\/rcsann.2021.0127","type":"journal-article","created":{"date-parts":[[2022,10,9]],"date-time":"2022-10-09T12:46:20Z","timestamp":1665319580000},"page":"100-105","source":"Crossref","is-referenced-by-count":6,"title":["CT angiograms for lower GI bleeding: the experience of a large UK teaching hospital"],"prefix":"10.1308","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2672-2373","authenticated-orcid":false,"given":"S","family":"Snelling","sequence":"first","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Ghaffar","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ST","family":"Ward","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"171","reference":[{"key":"C1","unstructured":"NCEPOD. 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