[Value of scintigraphy in the localization of digestive hemorrhage]

Scintigram imaging is a new means of localization of digestive tract hemorrhage, the radiopharmaceutic agent (technetium-labelled colloidal sulfur or technetium-labelled erythrocytes) accumulating at the bleeding site. The technique used consists of early recording over 80 minutes and then later serial imaging over 24 hours after radioisotope injection. The limitations and advantages of radioisotope investigations are discussed in relation to results in 6 patients with digestive hemorrhage explored by scintigraphy. When technetium-labelled erythrocytes are used the method is a non-invasive, simple and sensitive one for locating site of bleeding during the period of active hemorrhage. It appears to be complementary to arteriography, a more aggressive and less sensitive procedure, and to endoscopy, which explores small intestine and cecum with difficulty and cannot always determine the origin of the bleeding when other lesions exist. Experimental studies in the dog have shown that scintigraphy can detect digestive bleeding of about 0.1 to 0.2 ml/min, and this method of exploration should be used routinely when endoscopy and/or arteriography have not been performed or have given inconclusive results.