Evaluation of technetium-99m DTPA for localization of site of acute upper gastrointestinal bleeding.
Intravenous Tc-99m DTPA was evaluated in 34 patients with active upper gastrointestinal bleeding. Active bleeding was detected in 25 patients: nine in the stomach, 12 in the duodenum, and four from esophageal varices. No active bleeding was seen in nine patients (two gastric ulcers and seven duodenal ulcers). Results were correlated with endoscopic and/or surgical findings. All completely correlated except: 1) one case of esophageal varices in which there was disagreement on the site, 2) three cases of duodenal ulcers that were not bleeding on endoscopy but showed mild oozing on delayed images and 3) one case of gastric ulcer, in which no bleeding was detected in the Tc-99m DTPA study, but was found to be bleeding at surgery 24 hours later. The Tc-99m DTPA study is a reliable method for localization of upper gastrointestinal bleeding with an agreement ratio of 85%. This method also can be used safely for follow-up of patients with intermittent bleeding. It is less invasive than endoscopy, is easily repeatable, and has the same accuracy.
D000208:Acute Disease; D004381:Duodenal Ulcer / Q000150:complications; D004724:Endoscopy; D004932:Esophageal and Gastric Varices / Q000150:complications; D005069:Evaluation Studies as Topic; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D004369:Pentetic Acid; D010438:Peptic Ulcer Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology; D011877:Radionuclide Imaging; D013276:Stomach Ulcer / Q000150:complications; D013667:Technetium; D016284:Technetium Tc 99m Pentetate
D013667:Technetium; D004369:Pentetic Acid; D016284:Technetium Tc 99m Pentetate