title: Delayed 99mTc-labeled erythrocyte scintigraphy in patients with lower gastrointestinal tract hemorrhage: effect of positive findings on clinical management.
abstract: OBJECTIVE
  This study was performed to determine whether the results of delayed technetium 99m (99mTc)-labeled erythrocyte scintigraphy for lower gastrointestinal tract hemorrhage resulted in different clinical management and outcome from that in cases in which the results of initial scintigraphy were negative or equivocal.
  
  
  METHODS
  The authors retrospectively reviewed all 398 99mTc-labeled erythrocyte scintigraphic studies obtained emergently for lower gastrointestinal tract hemorrhage at their institution between January 1, 1994, and December 7, 2001. Of 67 patients who underwent delayed studies, 37 had positive findings (average delay, 18.4 hours; range, 6-25 hours) and 30 had negative findings (average delay, 20.1 hours; range, 8-26 hours). Clinical management and outcome were compared between these two groups with respect to duration of hospitalization, volume of blood transfusion, mortality, and the percentage who were treated conservatively or referred for angiography, endoscopy, and/or surgery.
  
  
  RESULTS
  Patients with positive delayed studies were referred more frequently for angiography than those with negative studies (35% vs 0%, P < .01). There were no significant differences between patients with positive findings and patients with negative findings with respect to mortality (8% vs 0%, P < .32), transfusion requirements (5.6 vs 3.2 units, P < .20), hospitalization (9.5 vs 6.1 days, P < .11), the percentage treated conservatively (35% vs 37%, P < .90), or the percentages referred for endoscopy (49% vs 60%, P < .50) or for surgery (24% vs 17%, P < .64).
  
  
  CONCLUSIONS
  Positive findings at delayed scintigraphy resulted in increased referrals for angiography but had no other effect on clinical course or outcome of lower gastrointestinal tract hemorrhage.
authors.affiliation: Department of Radiology, University of Chicago Hospitals, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637, USA.
authors.forename: J Herman
authors.initials: JH
authors.lastname: Kan
authors.forename: Brian
authors.initials: B
authors.lastname: Funaki
authors.forename: Brian D
authors.initials: BD
authors.lastname: O'Rourke
authors.forename: M Brent
authors.initials: MB
authors.lastname: Ward
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Appelbaum
mesh_terms: D000792:Angiography; D004064:Digestive System / Q000098:blood supply / Q000000981:diagnostic imaging; D004912:Erythrocytes; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D013667:Technetium
chemical_list: D013667:Technetium