An Evaluation of 99mTc-Labeled Red Blood Cell Scintigraphy for the Detection and Localization of Gastrointestinal Bleeding Sites

John A. Markisz, Dov Front, Henry D. Royal, Barry Sacks, J. Anthony Parker, Gerald M. Kolodny

Research output: Contribution to journalArticle

71 Scopus citations

Abstract

99mTechnetium-labeled red blood cell scintigraphy was performed upon 39 patients with clinical evidence for acute lower gastrointestinal bleeding from an unknown source. Seventeen of 39 patients (44%) had a scan that indicated active gastrointestinal bleeding. Scans became positive 6 or more h after injection, consistent with intermittent bleeding, in 8 of 17 patients (47%). In the 11 patients in whom the bleeding site was definitely identified by arteriography, surgery, or colonoscopy, scintigraphy correctly localized the bleeding site in 10 of 11 patients (91%). Four of 11 patients (36%) had an active bleeding site identified by arteriography. Ten of 17 patients (58%) with a positive scan required either gel foam embolization (4 patients) or surgery (6 patients) to control the bleeding, whereas only 1 of 22 patients (5%) required surgery when the scan was negative. Six deaths occurred in the scan-positive patients compared with no deaths in the scan-negative patients. None of the 8 patients who had arteriography and no active bleeding site by scintigraphy had arteriographically demonstrable active bleeding. Scintigraphy provides a reliable noninvasive test to screen patients in whom arteriography is being considered to localize active bleeding sites. If the arteriogram is negative, the scintigraphic findings alone may guide the surgical or arteriographic intervention. In addition, scintigraphy identifies two patient populations which have considerably different morbidity and mortality.

Original languageEnglish
Pages (from-to)394-398
Number of pages5
JournalGastroenterology
Volume83
Issue number2
DOIs
StatePublished - Jan 1 1982
Externally publishedYes

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