sincalide and Gastrointestinal-Hemorrhage

An 82-year-old man had his third episode of melanotic stool. Two previous workups had failed to localize the source of bleeding. A Tc-99m labeled RBC scan visualized the gallbladder early in the study. Administration of sincalide visually decreased the activity, confirming gallbladder activity. Three months later, at his second surgery, hepatic metastases were finally identified as the source of bleeding. In retrospect, the hepatic activity is inhomogeneous with at least two cold defects that could have represented hepatic metastases.

Topics: Adenocarcinoma; Aged; Diverticulum; Erythrocytes; Gallbladder; Gastrointestinal Hemorrhage; Hemobilia; Humans; Jejunal Diseases; Liver Neoplasms; Male; Neoplasms, Unknown Primary; Radionuclide Imaging; Sincalide; Sodium Pertechnetate Tc 99m