99mTc-RBC SPECT/CT for Duodenal Bleeding Point Detection

Area of Science:

• Nuclear Medicine
• Gastroenterology
• Diagnostic Imaging

Background:

• Acute melena and anemia necessitate prompt identification of gastrointestinal bleeding sources.
• Conventional endoscopic and imaging methods can sometimes fail to localize obscure bleeding sites.

Observation:

• A 63-year-old male presented with acute melena and low hemoglobin, with initial upper and lower gastrointestinal evaluations inconclusive.
• Technetium-99m red blood cell (Tc-RBC) planar scintigraphy indicated two potential bleeding sites in the lower abdomen.

Findings:

• SPECT/CT precisely localized the primary bleeding focus to the second and third parts of the duodenum, also noting jejunal blood accumulation.
• Esophagogastroduodenoscopy confirmed active spurting from a small vessel associated with multiple duodenal ulcers.

Implications:

• SPECT/CT is a valuable tool for precisely locating obscure gastrointestinal bleeding when other methods fail.
• Accurate localization via advanced nuclear imaging facilitates targeted endoscopic intervention and improves patient outcomes.