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[Scintigraphy of bleeding. The diagnostic value based on a 10-year period]
1Klinisk fysiologisk/nuklearmedicinsk afdeling, Hvidovre Hospital, København.
Insights
Technetium-99m labelled red blood cell scintigraphy effectively detects acute gastrointestinal bleeding. This imaging technique aids in localizing bleeding sites, guiding surgical intervention, and excluding ongoing hemorrhage when negative.
Area of Science:
- Nuclear Medicine
- Gastroenterology
- Diagnostic Imaging
Background:
- Gastrointestinal hemorrhage presents a significant diagnostic challenge.
- Accurate localization of bleeding is crucial for effective management.
Purpose of the Study:
- To evaluate the diagnostic utility of 99mTc-labelled red blood cell scintigraphy for gastrointestinal bleeding.
- To assess the correlation between scintigraphy findings and other diagnostic modalities.
Main Methods:
- Retrospective analysis of 85 patient records over a 10-year period.
- Review of clinical data, blood transfusions, and results from angiography, endoscopy, and surgery.
- Evaluation of scintigraphy findings for bleeding site localization.
Main Results:
- Scintigraphy successfully localized a bleeding site in 52% of cases.
- Scintigraphic localization was confirmed in 65% of positive cases by subsequent procedures.
- Negative scintigraphy results could not entirely exclude bleeding, with 10 of 40 patients later found to have bleeding.
Conclusions:
- 99mTc-labelled red blood cell scintigraphy is a valuable tool for identifying acute gastrointestinal hemorrhage.
- Scintigraphy-guided surgery is indicated for bleeding localization.
- A negative scintigraphy can help exclude ongoing gastrointestinal bleeding.
Abstract:
The purpose was to examine the diagnostic value of 99mTc-labelled red blood cell scintigraphy for detection of gastrointestinal haemorrhage. In a retrospective investigation 85 patient files over a 10 year period (1.1.1984-31.12.1993) were evaluated. Data regarding the patients' clinical condition, number of blood transfusions, findings with angiography, gastroscopy, colonoscopy, proctoscopy, operation, x-ray of colon and autopsy were registered. A bleeding site was localized in 52% of the scintigraphies. Among these patients the scintigraphic localization was confirmed or made "very possible" in 65% by operation, autopsy or one of the other mentioned diagnostic modalities. Among the 25 operated patients the localization of the bleeding site was confirmed in 19 patients. In 40 patients with a "negative" scintigraphy a bleeding site was found in 10 patients 1-18 days after the scintigraphy by operation or one of the listed diagnostic modalities. It is concluded that 99mTc-labelled red blood cell scintigraphy is a valuable diagnostic tool for identification of acute gastrointestinal haemorrhage. Operation after scintigraphic guidance is well indicated. A "negative" scintigraphy can only exclude ongoing bleeding from the gastrointestinal tract.