Localization of lower gastrointestinal hemorrhage. Experience with red blood cells labeled in vitro with technetium Tc 99m
P. M. Orecchia, E. K. Hensley, P. T. McDonald and R. J. Lull
Seventy-six patients clinically suspected of having lower gastrointestinal
bleeding were studied by scintigraphy utilizing red blood cells labeled in
vitro with technetium Tc 99m. Sixteen patients required emergency surgery;
bleeding was accurately localized in 15 (94%). One patient (6%) had a
normal scan. A 20-month mean follow-up of the 16 patients showed no
recurrent bleeding. Of 60 patients not requiring emergency surgery,
bleeding was localized in 11, but the bleeding ceased. Forty-nine of the 60
patients had normal scans and had no further hemorrhaging during
hospitalization. A 21-month mean follow-up of 38 of the 49 patients showed
no further bleeding episodes or surgical procedures in 29 patients;
however, eight patients required surgical procedures, including seven for
gastrointestinal malignancies. Scanning of red blood cells labeled in vitro
with 99mTc is accurate and efficacious in localization of bleeding sites
that require emergency surgery for lower gastrointestinal hemorrhage.
