Scintigraphic Detection of Acute Gastrointestinal Bleeding

Alavi, Abass; Dann, Robert; Baum, Stanley; Biery, Darryl N.

doi:10.1148/124.3.753

Cited by 152 publications

(57 citation statements)

References 4 publications

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“…Although the incidence of severe colonic bleeding is relatively low, it occurs most often in older people who suffer from concomitant medical problems [2, 3, 4, 5, 6, 7, 8, 9, 10, 11]. Patients with massive lower intestinal bleeding are often placed under careful observation and given transfusions because spontanous recovery often occurs.…”

Section: Discussionmentioning

confidence: 99%

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Analysis of Urgent Colonoscopy for Lower Gastrointestinal Tract Bleeding

Ohyama

Sakurai²,

Ito³

et al. 2000

Digestion

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Background: Three hundred and forty-five patients who underwent urgent colonoscopy for acute hematochezia during the past 20 years (from 1976 to 1995) were retrospectively analyzed. Methods: Urgent colonoscopy was defined as endoscopy performed within 24 h after a bleeding episode. Preparation was initially minimal with a water or glycerine enema. Recently, however, polyethylene glycol is used. Results: The overall diagnostic accuracy for bleeding site detection was 89.1% (307 cases). Successful insertion was made to the ileocecal region in 193 cases (55.9%). The disease most frequently discoverd by urgent colonoscopy was transient ischemic colitis (62 cases). Negative urgent colonoscopy specimens (18 cases) were later diagnosed by other methods as being small intestinal bleeding foci. In 10 cases, initial colonoscopy failed to detect the bleeding foci. Endoscopic hemostasis was performed in 48 cases. Permanent hemostasis succeeded in 32 cases (66.7%). Complications of urgent colonoscopy were fever after the examination (22 cases) and hypotension during endoscopy (7 cases). Conclusion: Urgent colonoscopy is considered to be a safe and useful examination for acute lower gastrointestinal bleeding and hemostasis.

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Section: Discussionmentioning

confidence: 99%

“…Clinically it involves many problems in diagnosis and treatment. Emergent angiography and scintigraphy have but limited value for detecting bleeding foci and are unable to control bleeding [1, 2, 3, 4, 5]. Ischemic colitis is accompanied by severe pain and is difficult to distinguish from the gangrenous type by barium enema [3, 4].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Urgent Colonoscopy for Lower Gastrointestinal Tract Bleeding

Ohyama

Sakurai²,

Ito³

et al. 2000

Digestion

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“…Among these, as a major advantage, scintigraphic methods permit the rendering of the visual image of the whole abdomen at the same time. [4] For this reason, some authors advocate the evaluation of patients with scintigraphic methods before undergoing endoscopy or angiography. [3,[5][6][7][8] The aim of this retrospective study is to report our clinical experience with red blood cell (RBC) scintigraphy and to discuss the role of this method in light of the contemporary literature.…”

Section: Resultsmentioning

confidence: 99%

Role of red blood cell scintigraphy for determining the localization of gastrointestinal bleeding

Şanlı

Özkan²,

Kuyumcu³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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AMAÇGastrointestinal sistem (GİS) kanamalarında kanama odağı-nın saptanmasında, Tc-99m ile işaretli eritrosit (RBC) sintigrafisinin rolü klinik deneyimlerimiz ışığında değerlendirildi. GEREÇ VE YÖNTEM1995-2010 yılları arasında GİS kanaması odağının belirlenmesi amacıyla kliniğimize gönderilen 57 hasta (27 kadın, 30 erkek; ortalama yaş 43.9±24; dağılım 1-91 yıl) geriye dönük olarak çalışmaya alındı. Sintigrafi öncesi hastaların 51'ine gastroskopi, 45'ine kolonoskopi, 9'una anjiyografi yapılmıştı. BULGULARRBC sintigrafisi hastaların 31'inde pozitif ve 26'sında negatifti. Pozitif sintigrafik bulgular, 19 hastada ilk bir saatlik dinamik imajlarda, 7 hastada 1-4. saatler arası statik imajlarda, 5 hastada ise 4-24. saatler arasında alınan statik imajlarda kaydedildi. Toplam 14 hasta GİS kanaması nedeniyle ameliyat edildi. On üç hastada kanama yeri RBC sintigrafisi tanısıyla doğrulandı (doğruluk: %92,8). Ameliyat edilmeyen 43 hastanın 12'sinde nedeni bilinmeyen demir eksikliği anemisi vardı ki bu hastaların tümünde sintigrafi negatif olarak sonuçlandı. Yoğun kanama bulguları olan 4 hasta medikal takip sürecinde kaybedildi, geri kalan 27 hastanın kanamaları kendiliğinden ya da konservatif tedavilerle durdu. SONUÇÇalışmamız aktif GİS kanamalarında kanama odağının belirlenmesinde sintigrafinin primer yöntem olması gerekliliğini göstermektedir. Özellikle ilk 1 saatlik dinamik görün-tüleme esnasında saptanan pozitif imajlar, kanama odağı-nın doğru yerinin saptanmasında ve cerrahi gerekliliğin belirlenmesinde yol göstericidir.Anahtar Sözcükler: Gastrointestinal kanama; işaretli eritrosit sintigrafisi; endoskopik girişimler.

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“…In contrast to the erythrocyte labelled method, there is also the possibility of using 99m Tc-labelled sulfur colloid scintigraphy. This method, first described in 1977 [26] , is also a successful tool for identification of bleeding sites, but may be problematic in the detection of bleeding in the stomach, proximal duodenum, or colonic flexures, due to intense radiotracer activity within the liver and the spleen. It has been shown that there is no practical advantage in the use of 99m Technetium labelled red blood cell scintigraphy over 99m Tc-labeled sulfur colloid scintigraphy [27] .…”

Section: Scintigraphy Withmentioning

confidence: 99%

Significance of scintigraphy for the localisation of obscure gastrointestinal bleedings

Brünnler

Klebl²,

Mundorff³

et al. 2008

WJG

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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.

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Scintigraphic Detection of Acute Gastrointestinal Bleeding

Cited by 152 publications

References 4 publications

Analysis of Urgent Colonoscopy for Lower Gastrointestinal Tract Bleeding

Analysis of Urgent Colonoscopy for Lower Gastrointestinal Tract Bleeding

Role of red blood cell scintigraphy for determining the localization of gastrointestinal bleeding

Significance of scintigraphy for the localisation of obscure gastrointestinal bleedings

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