Advanced CT angiography in detecting rare arterio-venous malformations: Addressing diagnostic challenges in obscure gastrointestinal bleeding

Gastrointestinal bleeding is a common clinical issue, but obscure gastrointestinal bleeding (OGIB) presents significant diagnostic challenges, especially when caused by arteriovenous malformations (AVMs). This study explored the role of advanced CT angiography (CTA) in diagnosing and managing AVM-related OGIB in 100 patients. CTA identified AVMs in 12% of cases where standard endoscopy failed (p < 0.001) and guided successful surgical control of bleeding in 95% of these cases. The sensitivity of CTA (92%) was significantly higher compared to other imaging modalities (68%; p = 0.002), particularly for small or inaccessible lesions. These findings underscore CTA's crucial role in improving diagnostic accuracy and enabling targeted therapeutic interventions for challenging cases of OGIB.