Fibroid Uterus Confounding the Correct Localization of Active Gastrointestinal Bleeding During Tc-99m RBC Scan

Gafton, Andreia R.; Caride, Vicente J.

doi:10.1097/01.rlu.0000227490.63768.d1

Cited by 8 publications

(4 citation statements)

References 9 publications

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“…Further limitations include lack of immediate availability, notably during on call hours, and subjectivity to false positive localization of a bleed due to tagged blood moving within the GI lumen during peristalsis (23) or position changes in the context of various non-GI pathologies e.g., uterine fibroids (24). The overall positive yield of red cell studies is reported to be ~50% (23).…”

Section: Diagnosismentioning

confidence: 99%

Small Bowel Gastrointestinal Bleeding Diagnosis and Management—A Narrative Review

2019

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Background: Small bowel bleeding accounts for 5–10% of all gastrointestinal bleeding. Despite advances in imaging, endoscopy and minimally invasive therapeutic techniques, its diagnosis and treatment remains a challenge and a standardized algorithm for approaching suspected small bowel bleeding remains elusive. Furthermore, the choice of investigation is subject to timing of presentation and accessibility to investigations. The aim of this study was to construct a narrative review of recent literature surrounding the diagnosis and management of small bowel bleeding. Methods: A literature review was conducted examining the database pubmed with the following key words and Boolean operators: occult GI bleed OR mesenteric bleed OR gastrointestinal hemorrhage OR GI hemorrhage AND management. Articles were selected and reviewed based on relevance to the research topic. Where necessary, the full text was sought to further assess relevance. Results: In overt GI bleeding, CT angiography and red cell scintigraphy are both feasible and reliable diagnostic imaging modalities if standard endoscopy is negative. Red cell scintigraphy may be advantageous through detection of lower bleeding rates but it is subject to availability. Overt bleeding and a positive CT angiogram or red cell scan improves the diagnostic yield of formal angiography ± embolization. Video capsule endoscopy or double balloon endoscopy can be considered in occult GI bleeding following normal upper and lower endoscopy. Conclusions: Small bowel bleeding remains a rare but significant diagnostic and therapeutic challenge. Technological advances in diagnostics have aided evaluation but have not broadened the range of therapeutic interventions.

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Section: Diagnosismentioning

confidence: 99%

Small Bowel Gastrointestinal Bleeding Diagnosis and Management—A Narrative Review

2019

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“…In addition, variable uterine activity during the ovulatory cycle causes fixed increased perfusion due to endometrial proliferation (76). Finally, a uterine leiomyoma may show transient, fixed activity due to hypervascularity (77)(78)(79).…”

Section: Increased Rbc Activity Due To Other Causesmentioning

confidence: 99%

The SNMMI Procedure Standard/EANM Practice Guideline for Gastrointestinal Bleeding Scintigraphy 2.0

Dam

Brandon

Grantham

et al. 2014

Journal of Nuclear Medicine Technology

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“…11 Many potential false-positive findings can occur in the 99m Tc-RBC bleeding, including arteriovenous malformation, 12 pelvic kidney, 13 hepatic hemangioma, 14 dilated mesenteric veins, 15 varices, [16][17][18] gallbladder in patients with renal failure, 19 and aortic aneurysm. 20 It is well-known that uterus in a woman who is pregnant, 21 shortly postpartum, 22 or having fibroid 23 can have elevated 99m Tc-RBC activity during the gastrointestinal bleeding scintigraphy. Our case further indicates that a detailed clinical history including menstrual status should be taken as part of the prestudy procedure in aiding accurate interpretation of 99m Tc-RBC bleeding study in childbearing age of women.…”

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confidence: 99%

Menstruation Confounding the Correct Interpretation of 99mTc-RBC Bleeding Scan

Wang,

Lu,

Wang

et al. 2023

Clin Nucl Med

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99mTc-RBC bleeding scan in a 17-year-old adolescent girl showed an increased focal activity in the pelvis. However, SPECT/CT showed that this activity was located in the uterus, which was considered a normal variant considering that the patient was in her fourth day of the menstrual period. Subsequent 99mTcO4 − Meckel scan showed the typical characteristic of ectopic gastric mucosa in the small bowel. Postsurgical pathology confirmed the diagnosis of ectopic gastric mucosa. This case suggested the menstrual period uterus should be included as differential diagnosis of 99mTc-RBC scan.

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Fibroid Uterus Confounding the Correct Localization of Active Gastrointestinal Bleeding During Tc-99m RBC Scan

Cited by 8 publications

References 9 publications

Small Bowel Gastrointestinal Bleeding Diagnosis and Management—A Narrative Review

Small Bowel Gastrointestinal Bleeding Diagnosis and Management—A Narrative Review

The SNMMI Procedure Standard/EANM Practice Guideline for Gastrointestinal Bleeding Scintigraphy 2.0

Menstruation Confounding the Correct Interpretation of 99mTc-RBC Bleeding Scan

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