sodium-pertechnetate-tc-99m and Intestinal-Diseases

To present our experience with the detection of bleeding in the small intestine by means of scintigraphy with in vivo-labelled red blood cells (RBCs) in the period of 1998-2009.. A 12-year prospective study was accomplished with 40 patients (23 men, 17 women, aged 12-91, mean 56 years) who had lower gastrointestinal bleeding (obscure-overt bleeding) and underwent scintigraphy with in vivo-labelled RBCs by means of technetium 99m. The scintigraphy was usually performed after other diagnostic tests had failed to locate the bleeding.. A total of 26 patients had a positive scintigraphy with in vivo-labelled RBCs and 14 patients had negative scintigraphy. The final diagnosis was confirmed in 20 of 26 patients with a positive scintigraphy by push enteroscopy (6/20), intraoperative enteroscopy (7/20), surgery (4/20), duodenoscopy (1/20), double-balloon enteroscopy (1/20) and X-ray angiography (1/20). The correct location of the bleeding site was identified by RBC scintigraphy in 15 of 20 (75%) patients with the confirmed source. The locations of the bleeding site identified by scintigraphy and enteroscopy (push, intraoperative) and surgical investigations were highly correlated in patients with a positive scintigraphy within the first 3 h. Eleven of the 20 correctly localized studies and none of the incorrectly localized studies were positive in the dynamic phase of imaging. In 5 patients (all erroneously localized), scintigraphy was positive only at a period longer than 18 h.. RBC scintigraphy is an effective imaging modality in localizing lower gastrointestinal bleeding in patients for whom other diagnostic tests have failed to locate the bleeding. RBC scintigraphy can be successful in the detection of bleeding sites in the small intestine.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Colon; Endoscopy, Gastrointestinal; Erythrocytes; Female; Gastrointestinal Hemorrhage; Humans; Intestinal Diseases; Intestine, Small; Male; Middle Aged; Prospective Studies; Sodium Pertechnetate Tc 99m; Time Factors; Tomography, Emission-Computed, Single-Photon; Young Adult

Topics: Capsule Endoscopy; Child; Choristoma; Diagnosis, Differential; Female; Gastric Mucosa; Humans; Intestinal Diseases; Intestine, Small; Multimodal Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

We highlight the spectrum of scintigraphic findings likely to be encountered in patients with ectopic gastric mucosa with illustrative cases for each such finding. 11 children (aged 4 months to 120 months, all males) underwent (99)Tc(m)-pertechnetate scintigraphic evaluation for ectopic gastric mucosa. Functioning ectopic gastric mucosa was detected in Meckel's diverticulae in three patients, in small bowel duplications in four, in a gastric duplication in one, and in intrathoracic foregut duplication cysts in three. Ectopic functioning gastric mucosa in Meckel's diverticulum, and gastric duplication is visualized simultaneously with the stomach while in intestinal duplications tracer activity can be visualized in the dynamic sequence and even before gastric tracer visualization. In the three patients with intrathoracic duplication cysts, the functioning ectopic gastric mucosa was evident only in the delayed (99)Tc(m)-pertechnetate images, much later than the visualization of stomach activity. Therefore, acquisition of delayed images are useful when the initial images are equivocal or negative in children with intrathoracic foregut duplication cysts. In addition, we suggest a hypothesis of a possible mechanism for the uptake of pertechnetate in ectopic gastric mucosa in some patients with intrathoracic forget duplication cysts. In conclusion, a variety of scintigraphic patterns may be found in patients with ectopic gastric mucosa undergoing (99)Tc(m)-pertechnetate scintigraphy depending upon the location and size of the ectopic tissue.

Topics: Child; Child, Preschool; Choristoma; Cysts; Gastric Mucosa; Gastrointestinal Diseases; Humans; Ileal Diseases; Infant; Intestinal Diseases; Intestine, Small; Male; Meckel Diverticulum; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Stomach; Stomach Diseases

A case of a small bowel tubular duplication is described. It was lined with ectopic gastric mucosa which showed a perforation. The diagnosis was made preoperatively by Tc-99m pertechnetate scintigraphy.

Topics: Choristoma; Congenital Abnormalities; Gastric Mucosa; Humans; Infant; Intestinal Diseases; Intestinal Perforation; Intestine, Small; Male; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

Topics: Female; Gastrointestinal Hemorrhage; Humans; Intestinal Diseases; Leiomyoma; Middle Aged; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Uterine Neoplasms

Bleeding ulcerative lesions of the small intestine often present difficult diagnostic problems. Useful techniques to establish a diagnosis include abdominal scintigraphy using technetium 99-m pertechnetate and intraoperative endoscopic examination of the intestine. Our experience with these techniques is based on 25 patients who were treated in 1974-1983. In 18 adults, the diagnoses included Crohn's disease, non-specific ulcers and intestinal tuberculosis. In 6 of the 18 adults, the source of bleeding was difficult to determine during laparotomy and diagnosis was established by intraoperative endoscopic examination. In the seven children, the diagnoses included ectopic gastric mucosa and lymphoid hyperplasia. In the children, abdominal scintigraphy was used as a preoperative measure to detect the bleeding source.

Topics: Adolescent; Adult; Aged; Child, Preschool; Endoscopy; Female; Gastrointestinal Hemorrhage; Humans; Infant; Intestinal Diseases; Intestine, Small; Intraoperative Period; Male; Middle Aged; Preoperative Care; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Ulcer