Positive In-111 WBC scan in a patient with ischemic ileocolitis and negative colonoscopies

Area of Science:

• Nuclear medicine imaging
• Gastrointestinal diagnostics

Background:

• Ischemic bowel disease diagnosis often relies on endoscopic visualization.
• Subacute presentations can delay diagnosis and treatment.
• The utility of Indium-111 white blood cell (WBC) scans in early detection needs further exploration.

Observation:

• A case presented with angiographic evidence of ileocolitis.
• Repeated colonoscopies did not reveal mucosal changes consistent with the diagnosis.
• An Indium-111 WBC scan showed abnormalities prior to endoscopic detection.

Findings:

• Indium-111 WBC scintigraphy identified early ischemic bowel disease.
• Diagnostic findings on WBC scan preceded observable mucosal changes during colonoscopy.
• The case suggests WBC scans can detect subacute ischemic processes.

Implications:

• Indium-111 WBC scans may offer an earlier diagnostic tool for ischemic bowel disease.
• This imaging modality could be valuable in identifying subacute cases.
• Integrating nuclear medicine into diagnostic algorithms may improve patient outcomes.