sodium-pertechnetate-tc-99m and Anemia

Lower gastrointestinal bleeding (LGIB) in infants and children is a difficult diagnostic problem largely due to limitations of small-bowel evaluation. Duplication cysts are rare congenital malformations with variable clinical presentation. This report describes seven children (five boys, two girls and median age 10 [1.5-124] months) with ileal duplication cysts who presented with LGIB of varying severity from stool occult blood positivity with anemia to fresh bleeding per rectum. Diagnosis was made by Tc(99m) pertechnetate scan (n-5), balloon enteroscopy (n-1), and at laparotomy (n-1). Ultrasonography and barium meal follow-through missed the diagnosis in six and three cases, respectively. All cases underwent surgery with resection of the duplication cyst and complete removal of the mucosa containing ectopic gastric tissue while preserving adequate bowel length. A good postoperative outcome with complete symptom resolution was seen in all. Enteric duplication cyst should always be considered in children presenting with occult or overt lower gastrointestinal hemorrhage, and Tc(99m) pertechnetate scan should be done prior to invasive tests like balloon enteroscopy.

Topics: Anemia; Child; Child, Preschool; Cysts; Endoscopy, Gastrointestinal; Female; Gastrointestinal Hemorrhage; Humans; Ileal Diseases; Infant; Male; Occult Blood; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Tomography, Emission-Computed; Ultrasonography

Topics: Anemia; Burkitt Lymphoma; Child, Preschool; Diagnosis, Differential; Humans; Ileal Diseases; Ileal Neoplasms; Incidental Findings; Intussusception; Male; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m

Hemangioma of the small intestine is rare, and the preoperative diagnosis of it is difficult. We report a patient with gastrointestinal bleeding for whom Tc-99m-labeled red blood cell scintigraphy was useful in diagnosing cavernous hemangioma of the small intestine. A 25-year-old man was referred to our hospital for recurrent iron deficiency anemia. Because of the patient's severe anemia, imaging was performed to locate the bleeding lesion in the gastrointestinal tract. Scintigraphy with Tc-99m-labeled red blood cells revealed pooling indicating a tumor and extravasation of blood from the tumor. Scintigraphy with Tc-99m pertechnetate revealed no abnormal accumulation. Partial resection of the small intestine was done, and cavernous hemangioma of the small intestine was diagnosed by using the specimen of resected tissue.

Topics: Adult; Anemia; Capillaries; Erythrocytes; Gastrointestinal Hemorrhage; Hemangioma, Cavernous; Humans; Intestinal Mucosa; Intestinal Neoplasms; Intestine, Small; Male; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m