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[99mTc red blood cell scintigraphy for the assessment of active gastrointestinal bleeding]
1Departamento de Radiologia, Hospital Clínico, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Insights
Technetium-99m red blood cell scintigraphy is a sensitive diagnostic tool for gastrointestinal bleeding. This method achieved 91% sensitivity in patients with negative upper endoscopy, aiding in identifying bleeding sites.
Area of Science:
- Nuclear Medicine
- Gastroenterology
- Diagnostic Imaging
Background:
- 99mTc red blood cell scintigraphy is a non-invasive diagnostic method for low-flow gastrointestinal bleeding.
- Assessing its utility in patients with negative upper endoscopy is crucial.
Purpose of the Study:
- To evaluate the diagnostic yield of 99mTc red blood cell scintigraphy.
- Focus on patients with gastrointestinal bleeding and negative upper endoscopy.
Main Methods:
- Reviewed clinical records of 59 patients (6-90 years) with active GI bleeding.
- All patients underwent 99mTc red blood cell scintigraphy; 20 had selective arteriography.
- Upper gastrointestinal endoscopy was non-diagnostic in all cases.
Main Results:
- Scintigraphy was positive in 40 patients, with 57% positive within the first hour.
- 93% of patients with a final diagnosis had the bleeding site correctly identified by scintigraphy.
- Negative scintigraphy often correlated with no active bleeding at the time of examination.
Conclusions:
- 99mTc red blood cell scintigraphy demonstrated 91% sensitivity for active gastrointestinal bleeding.
- It is a valuable tool for diagnosing GI bleeding when upper endoscopy is negative.
- The method aids in identifying the bleeding site in a significant majority of diagnosed cases.
Background:
99mTc red blood cell scintigraphy is a non invasive diagnostic method for low flow gastrointestinal bleeding.
Aim:
To assess the diagnostic yield of this method in patients admitted with gastrointestinal bleeding in whom upper gastrointestinal endoscopy was negative.
Patients And Methods:
The clinical records of 59 patients, aged 6 to 90 years old (35 male), with active gastrointestinal bleeding subjected to a 99mTc red blood cell scintigraphy were reviewed. All had non diagnostic upper gastrointestinal endoscopic studies, and in 20 a selective arteriography was performed.
Results:
In 40 patients the scintigraphy was positive for gastrointestinal bleeding, and in 57% of these the exam was positive during the first hour. Fifteen of the 19 patients with a negative scintigraphy did not have an active clinical bleeding at the moment of the examination. In 24 patients, a final etiological diagnosis was reached. In 93% of these patients scintigraphy correctly identified the bleeding site. In one patient with a negative scintigraphy, angiography disclosed a pseudo aneurysm of the splenic artery that was not bleeding actively.
Conclusions:
In these patients with negative upper gastrointestinal endoscopy 99mTc red blood cell scintigraphy had a 91% sensitivity for the diagnosis of active gastrointestinal bleeding.