Scientific paperImplications of negative technetium 99m–labeled red blood cell scintigraphy in patients presenting with lower gastrointestinal bleeding
Section snippets
Patients and Methods
After institutional review board approval, a retrospective analysis of all 99mTc-labeled RBC scintigraphy studies at a single tertiary care level institution (Ochsner Clinic Foundation, New Orleans, LA) between July 1, 1999 and July 31, 2005 was performed. During this 6-year period, 170 patients underwent 227 99mTc scans for the evaluation of GI hemorrhage. One hundred thirteen of these scans were negative for active bleeding. Scans performed for the evaluation of upper or lower GI hemorrhage
Results
Over a 6-year period, 84 negative 99mTc scans were obtained on admission assessments of patients with clinical evidence of lower GI hemorrhage. This group consisted of 43 male (51%) and 41 female (49%) patients, with an average age of 75.2 (±11.01) years. Forty-nine patients (58%) had a prior history of lower GI bleeding. The mean admission Hct was 33.3 (±6.92), and the mean Hct nadir was 26.74 (±4.62). A mean of 2.87 (±2.6) units of PRBCs per patient were transfused during hospitalization. The
Comments
The evaluation and treatment of massive lower GI hemorrhage can be perplexing to even the most experienced clinician. Once patient resuscitation has been initiated and a thorough history and physical examination have been performed, multiple diagnostic modalities are available to characterize the site and cause of bleeding. In addition to their diagnostic capacities, colonoscopy and angiography can be used for therapeutic purposes in many instances. Radionuclide bleeding scintigraphy, using 99m
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