Computed Tomography Angiography in Acute Gastrointestinal and Intra-abdominal Bleeding in Children: Preliminary Experience Dimitri A. Parra, MD, Govind.

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Presentation transcript:

Computed Tomography Angiography in Acute Gastrointestinal and Intra-abdominal Bleeding in Children: Preliminary Experience Dimitri A. Parra, MD, Govind B. Chavhan, MD, Amer Shammas, MD, Philip R. John, MBChB, FRCR Canadian Association of Radiologists Journal Volume 64, Issue 4, Pages 345-350 (November 2013) DOI: 10.1016/j.carj.2012.12.002 Copyright © 2013 Terms and Conditions

Figure 1 Axial computed tomography angiography image, showing a pelvic pseudoaneurysm in the left pelvis (arrows); postsurgical changes of a recent biopsy are seen. Canadian Association of Radiologists Journal 2013 64, 345-350DOI: (10.1016/j.carj.2012.12.002) Copyright © 2013 Terms and Conditions

Figure 2 A 3-dimensional volume-rendered image, showing the left pelvic pseudoaneurysm arising from the superior gluteal artery. Canadian Association of Radiologists Journal 2013 64, 345-350DOI: (10.1016/j.carj.2012.12.002) Copyright © 2013 Terms and Conditions

Figure 3 Conventional catheter angiography of the pelvis confirmed the left pelvic pseudoaneurysm filling from the superior gluteal artery. Canadian Association of Radiologists Journal 2013 64, 345-350DOI: (10.1016/j.carj.2012.12.002) Copyright © 2013 Terms and Conditions

Figure 4 Coronal computed tomography angiography image, showing a large left hepatic mass with discontinuity of its lower margin suspicious of rupture. A significant hemoperitoneum is observed. Canadian Association of Radiologists Journal 2013 64, 345-350DOI: (10.1016/j.carj.2012.12.002) Copyright © 2013 Terms and Conditions

Figure 5 Sagittal computed tomography angiography image, showing an area suspicious of contrast extravasation in the lower margin of the tumour (arrow). Canadian Association of Radiologists Journal 2013 64, 345-350DOI: (10.1016/j.carj.2012.12.002) Copyright © 2013 Terms and Conditions

Figure 6 Coronal computed tomography angiography image, demonstrating a prominent left hepatic artery with multiple small branches directed towards the liver mass (arrows). Canadian Association of Radiologists Journal 2013 64, 345-350DOI: (10.1016/j.carj.2012.12.002) Copyright © 2013 Terms and Conditions

Figure 7 Selective catheter angiography of the common hepatic artery, showing that the left liver mass received arterial supply from multiple branches of the left hepatic artery. Canadian Association of Radiologists Journal 2013 64, 345-350DOI: (10.1016/j.carj.2012.12.002) Copyright © 2013 Terms and Conditions

Figure 8 Selective catheter angiography of the left hepatic artery, showing the arterial supply to the liver mass; this site was chosen for embolization of the lesion. Canadian Association of Radiologists Journal 2013 64, 345-350DOI: (10.1016/j.carj.2012.12.002) Copyright © 2013 Terms and Conditions

Figure 9 Computed tomography of the abdomen, showing significant small bowel thickening compatible with post-transplantation lymphoproliferative disease (arrows). Canadian Association of Radiologists Journal 2013 64, 345-350DOI: (10.1016/j.carj.2012.12.002) Copyright © 2013 Terms and Conditions

Figure 10 Axial computed tomography angiography maximum intensity projection image, showing an area of contrast extravasation in the small bowel wall adjacent to the ileostomy (arrow). Canadian Association of Radiologists Journal 2013 64, 345-350DOI: (10.1016/j.carj.2012.12.002) Copyright © 2013 Terms and Conditions

Figure 11 (A) Axial maximum intensity projection image of the lower abdomen, showing a large vascular tumour in the right lower quadrant (arrows). (B) A 3-dimensional volume-rendered (VR) image, demonstrating the extension of the lesion. (C) A 3-dimensional VR image, showing an enlarged superior mesenteric artery that provides arterial supply to the lesion, a prominent draining vein, and an enlarged superior mesenteric vein. Canadian Association of Radiologists Journal 2013 64, 345-350DOI: (10.1016/j.carj.2012.12.002) Copyright © 2013 Terms and Conditions