Abstract
Objective: A 63-yr-old male with history of metastatic carcinoid tumor and heme-positive stool was referred for a bone scan. We attempted to determine if obtaining serial images would be helpful in characterizing the nature of extraosseous activity seen in the bowel region.
Methods: We performed delayed whole-body bone imaging and then serial imaging on the patient.
Results: The delayed whole-body bone imaging demonstrated extraosseous activity in the area of the descending and sigmoid colon. During additional serial imaging, the activity progressed to the area of the rectum, suggesting that the patient had experienced a gastrointestinal bleed subsequent to initial tracer injection. There was no evidence of free pertechnetate by imaging or chromatographic criteria, nor reason to suspect a vesicoenteric/colic fistula.
Conclusion: This case report demonstrates that serial imaging of extraosseous abdominal activity seen on bone scintigraphy may be helpful to differentiate a gastrointestinal bleeding pattern from other etiologies.
