6533b7cffe1ef96bd1259ab8

RESEARCH PRODUCT

Abdominal scintigraphy for diagnosis of intestinal bleeding

subject

description

Abdominal scintigraphy with99mTc-pertechnetate, using a gamma-camera linked to a data processor, was done in 8 patients with acute massive intestinal hemorrhage and in 34 patients with chronic recurrent intestinal hemorrhage. Endoscopy and x-ray studies had failed in all patients to reveal a bleeding source. All but 3 patients underwent exploratory laparotomy, confirming the abnormal findings of scintigraphy. In all acutely bleeding patients, scintigraphy was positive. The bleeding was proven by laparotomy to be due to Meckel's diverticulum with gastric mucosa in 5, jejunal neurinoma in 1, and sigmoid colon carcinoma in 1 patient. Scintigraphy was positive in only 3 chronically bleeding patients, 1 of whom had a Meckel's diverticulum with gastric mucosa and 2 of whom had bleeding colon polyps. Scintigraphy was equivocal in 10 patients, 7 of whom were found to have chronic inflammation of the appendix, and it was negative in 21 patients, including 1 who had a Meckel's diverticulum without gastric mucosa. In chronic intestinal hemorrhage, abdominal scintigraphy was only occasionally helpful for locating a bleeding source. In acute intestinal bleeding, however, scintigraphy was a useful test, particularly in identifying a Meckel's diverticulum with gastric mucosa in children.