sodium-pertechnetate-tc-99m and Ulcer

A patient with a chronic occult gastrointestinal bleeding site is described. Because an extensive examination failed to locate the site of bleeding, a heparin infusion was used in conjunction with a conventional Tc-99m labeled red cell bleeding study. A mid-jejunal ulcer was safely localized before elective surgery. A protocol for a heparin provocative bleeding study is proposed.

Topics: Aged; Chronic Disease; Erythrocytes; Female; Gastrointestinal Hemorrhage; Heparin; Humans; Jejunal Diseases; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Ulcer

Congenital rests of gastric epithelium have been reported in a variety of head and neck locations. Presenting symptoms of these lesions range from an asymptomatic cyst to one which is compromising the airway. The true diagnosis is rarely suspected prior to excision. A case of a gastric choristoma of the tongue is presented which was noted at birth as an intermittently bleeding ulcer. Complete excision of the mass was difficult to ascertain due to poor delineation of the tumor margins from the tongue musculature. A postoperative technetium-99m pertechnetate scan failed to demonstrate residual gastric mucosa. Conservative management resulted in only transient healing of the ulcer. Repeat excision demonstrated abundant residual gastric mucosa. Technetium-99m pertechnetate scanning may not be a reliable indicator of ectopic gastric mucosa in the head and neck region.

Topics: Choristoma; Diagnosis, Differential; Humans; Infant, Newborn; Male; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Stomach; Tongue Diseases; Tongue Neoplasms; Ulcer

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