sodium-pertechnetate-tc-99m and Melena

Topics: Adolescent; False Negative Reactions; Humans; Male; Melena; Radionuclide Imaging; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Anti-Ulcer Agents; Child; Gastrointestinal Hemorrhage; Hematemesis; Humans; Ileal Diseases; Male; Meckel Diverticulum; Melena; Pantoprazole; Proton Pump Inhibitors; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m

In four patients, women aged 65 and 86 years and men aged 22 and 46 years, admitted with profuse loss of fresh blood per anum, acute haemorrhage in the lower gastrointestinal tract was diagnosed. A systematic diagnostic and therapeutic strategy increases the possibility of localising the bleeding site in such patients. Urgent colonoscopy after oral purge for cleansing the colon of stool is feasible, safe and often both diagnostic and therapeutic. Dependent on local expertise, erythrocyte scintigraphy and (or) mesenteric angiography can further improve the locating of the bleeding site. However, in 10% of the patients the bleeding site remains unclear. In these cases surgical intervention may be necessary. Additional peroperative endoscopy, injection of methylene blue via a selective catheter or the construction of multiple stomas can be helpful. Blind colon resections should be avoided. The localisations in the four patients were: angiodysplastic focus in the caecum, a superficially eroded vein in the ileum, a Meckel's diverticulum, and multifocal vasculitis.

Topics: Acute Disease; Adult; Aged; Aged, 80 and over; Angiodysplasia; Angiography; Cecal Diseases; Colonoscopy; Diagnosis, Differential; Diagnostic Techniques, Surgical; Female; Humans; IgA Vasculitis; Ileum; Male; Meckel Diverticulum; Melena; Mesenteric Arteries; Middle Aged; Sodium Pertechnetate Tc 99m; Tomography, Emission-Computed

Topics: Adolescent; Catheterization; Dilatation, Pathologic; Humans; Kidney Failure, Chronic; Male; Meckel Diverticulum; Melena; Peritoneal Dialysis; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Stomach

Topics: Child, Preschool; Gastric Mucosa; Gastrointestinal Hemorrhage; Humans; Ileum; Intestinal Mucosa; Intestine, Small; Male; Melena; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m

Topics: Adult; False Negative Reactions; Female; Humans; Meckel Diverticulum; Melena; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

Using a modified in vivo Tc-99M red cell labeling technique, gastrointestinal bleeding scintigraphy was performed in 100 patients with GI bleeding. Sixty-two patients with melena or bright red blood per rectum had positive scintiscans. In comparison to results of angiography, endoscopy, surgery and contrast radiography, radionuclide scintigraphy correctly located the site of bleeding in 83% of patients. The procedures could be performed over a 24 hr period which increased the sensitivity of the test since 85% of the scintiscans were positive at one hr or greater after the onset of imaging. The procedure was more sensitive than angiography in detecting sources of GI bleeding. We conclude that GI bleeding scintigraphy 99mTc-red cells in an accurate and effective method to detect upper and lower GI bleeding in patients with acute intermittent gastrointestinal bleeding.

Topics: Adolescent; Adult; Aged; Angiography; Endoscopy; Erythrocytes; Female; Gastrointestinal Hemorrhage; Humans; Isotope Labeling; Male; Melena; Middle Aged; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium; Time Factors