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Red blood cell scintigraphy in children with acute massive gastrointestinal bleeding
Jung Lee1, Ming-Wei Lai, Chien-Chang Chen
1Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung Children's Hospital, Taoyuan, Taiwan.
Insights
Technetium-99m-labeled red blood cell scintigraphy ((99m)Tc RBC scan) is a sensitive tool for detecting acute massive gastrointestinal bleeding in children. Early positive scans within 2 hours help guide surgical interventions.
Area of Science:
- Pediatric Gastroenterology
- Nuclear Medicine Imaging
Background:
- Acute massive gastrointestinal (GI) bleeding in children presents diagnostic challenges.
- Technetium-99m-labeled red blood cell scintigraphy ((99m)Tc RBC scan) is a potential imaging modality.
Purpose of the Study:
- To evaluate the usefulness and diagnostic accuracy of (99m)Tc RBC scanning in pediatric patients with massive GI bleeding.
Main Methods:
- Retrospective analysis of medical records for pediatric patients undergoing (99m)Tc RBC scans for massive GI bleeding.
- Review of 23 scans performed between November 1991 and December 2004.
Main Results:
- The study included 22 pediatric patients.
- The overall diagnostic sensitivity of (99m)Tc RBC scanning was 39.1% (9 out of 23 scans).
- Positive scans within 2 hours showed a high correlation with lesion location for surgical guidance.
Conclusions:
- The (99m)Tc RBC scan is a sensitive but non-specific method for detecting GI bleeding in children.
- Early positive scans aid in directing surgical intervention and angiography.
- Definitive diagnosis often requires further investigation, such as laparotomy.
Background:
The main topic of the current review is the usefulness of technetium-99m-labeled red blood cell scintigraphy ((99m)Tc RBC scan) in children with acute massive gastrointestinal (GI) bleeding.
Methods:
The medical records of pediatric patients who experienced massive GI bleeding and who underwent (99m)Tc RBC scanning between November 1991 and December 2004 were reviewed and analyzed retrospectively.
Results:
The study included 22 patients who underwent 23 (99m)Tc RBC scans. The scans were usually performed after other diagnostic tests failed to locate the bleeding. The diagnostic sensitivity of the scans was nine out of 23 (39.1%). The test demonstrated a positive scan within the first 2 h in six patients, and three patients had positive results at 24 h. The locations of the lesions identified on scanning and surgical investigation were highly correlated in patients with a positive scan within 2 h.
Conclusions:
The (99m)Tc RBC scan is a sensitive, albeit non-specific, method for detecting GI bleeding. The location of a lesion as indicated by a positive scan within 2 h is helpful for guiding surgical intervention and angiography, although a definitive diagnosis should be made with other methods, particularly laparotomy.
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