AIM:To determine the role of scintigraphy in patients with gastrointestinal (GI) bleeding of unknown localization. METHODS:We performed retrospective analyses on 92 patients receiving scintigraphies from 1993 to 2000 in the University of Regensburg hospital, which were done for localization of GI bleeding as a diagnostic step after an unsuccessful endoscopy. In addition to the scintigraphies, further diagnostic steps such as endoscopy, angiography or operations were performed. In some of the scintigraphies with negative results, a provocation test for bleeding with heparinisation was carried out. RESULTS: 73% of all scintigraphies showed a positive result. In 4.5% of the positive results, the source was located in the stomach, in 37% the source was the small bowel, in 25% the source was the right colon, in 4.5% the source was the left colon, and in 20% no clear localization was possible. Only 4% of all scintigraphies were false positive. A reliable positive scintigraphy was independent of the age of the examined patient. A provocation test for bleeding with heparin resulted in an additional 46% of positive scintigraphies with a reliable localization in primary negative scintigraphies. CONCLUSION: Our results show that scintigraphy and scintigraphy with heparin provocation tests are reliable procedures. They enable a reliable localization in about half of the obscure GI-bleeding cases. Scintigraphy is superior to angiography in locating a bleeding. It is shown that even in the age of video capsule endoscopy and double-balloon enteroscopy, scintigraphy provides a reliable and directed localization of GI bleeding and offers carefully targeted guidance for other procedures.
222 Kraemer M, et al. Komplikationen chronisch entzªDarmerkrankungen im Alter colopr(x:lology 1998;20:222-8 (Nr. 6) Complications in Inflammatory Bowel Disease in Elderly PatientsAbstract: A retrospective study was performed to assess the efficacy of surgical therapeutic concepts for the treatment of ulcerative colitis and Crohn's disease in elderly patients. The study covered a 12-year period and included all patients undergoing hospital treatment for inflammatory bowel disease (IBD)-related complications at our institution. Patients 50 years and older were analyzed separately. All relevant clinical parameters, course and outcome were recorded, including a detailed complication and mortality analysis. 63 of 356 admissions for IBD were elderly patients. 20% of these were for severe, potentially life-threatening manifestations, with a high proportion of hitherto undiagnosed IBD (23%). Complication rates were significantly higher in elderly patients in all categories of urgency of admission. In a separate univariate analysis the following risk factors were found to be significantly associated with postoperative complications: 3 or more modified criteria according to Truelove, age of 50 of older, associated diseases, blood transfusion requirement. Significant risk factors for mortality were: 3 or more criteria according to Truelove, age of 50 or older, postoperative complications. The modified criteria according to Truelove, originally formulated for the clinical assessment of severity of colitis were thus shown to be of predictive value also for other IBD-related complications. Mortality in elderly patients was 5% and limited entirely to the group of severe manifestations. Ir was shown that all cases with lethal outcome were directly associated with procedure-related postoperative complications. This carries implications for an optimized operative approach to inflammatory bowel disease in the elderly, which are discussed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.