title: Hemobilia presenting as intermittent gastrointestinal hemorrhage with sincalide confirmation. A case report.
abstract: An 82-year-old man had his third episode of melanotic stool. Two previous workups had failed to localize the source of bleeding. A Tc-99m labeled RBC scan visualized the gallbladder early in the study. Administration of sincalide visually decreased the activity, confirming gallbladder activity. Three months later, at his second surgery, hepatic metastases were finally identified as the source of bleeding. In retrospect, the hepatic activity is inhomogeneous with at least two cold defects that could have represented hepatic metastases.
authors.affiliation: King/Drew Medical Center, Department of Radiology, Los Angeles, CA 90059, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Spieth
authors.forename: C C
authors.initials: CC
authors.lastname: Hou
authors.forename: P D
authors.initials: PD
authors.lastname: Ewing
authors.forename: D K
authors.initials: DK
authors.lastname: Price
authors.forename: R L
authors.initials: RL
authors.lastname: Kimura
authors.forename: T K
authors.initials: TK
authors.lastname: Kawada
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000556:secondary; D000368:Aged; D004240:Diverticulum / Q000150:complications; D004912:Erythrocytes; D005704:Gallbladder / Q000000981:diagnostic imaging*; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology; D006431:Hemobilia / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D007579:Jejunal Diseases / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000556:secondary; D008297:Male; D009382:Neoplasms, Unknown Primary; D011877:Radionuclide Imaging; D012844:Sincalide; D013670:Sodium Pertechnetate Tc 99m
chemical_list: D013670:Sodium Pertechnetate Tc 99m; D012844:Sincalide