Omental Hernia as a Potential Cause of False-Positive GI Bleeding on 99m Tc-RBC Scintigraphy

Gastrointestinal bleeding scintigraphy is a noninvasive study used to determine the presence of active bleeding, localize the bleeding site, and estimate the bleeding volume for prognostic purposes in patients with suspected gastrointestinal bleeding. However, it is important to note that false-positive results can occur due to various reasons. In this case, we present the scenario of a middle-aged woman who exhibited symptoms of gastrointestinal bleeding and underwent 99m Tc-RBC scintigraphy. The imaging revealed an accumulation of radiotracer in the hypogastric region, which was later determined to be caused by an omental hernia on SPECT/CT images. The herniated structure caused congestion in the mesenteric vessels, leading to the accumulation of 99m Tc-RBC. This case highlights the significance of considering anatomical anomalies and nonbleeding pathologies when interpreting the 99m Tc-RBC scintigraphy results for gastrointestinal bleeding.