Red blood cell scintigraphy in children with acute massive gastrointestinal bleeding.
BACKGROUND
The main topic of the current review is the usefulness of technetium-99m-labeled red blood cell scintigraphy ((99m)Tc RBC scan) in children with acute massive gastrointestinal (GI) bleeding.


METHODS
The medical records of pediatric patients who experienced massive GI bleeding and who underwent (99m)Tc RBC scanning between November 1991 and December 2004 were reviewed and analyzed retrospectively.


RESULTS
The study included 22 patients who underwent 23 (99m)Tc RBC scans. The scans were usually performed after other diagnostic tests failed to locate the bleeding. The diagnostic sensitivity of the scans was nine out of 23 (39.1%). The test demonstrated a positive scan within the first 2 h in six patients, and three patients had positive results at 24 h. The locations of the lesions identified on scanning and surgical investigation were highly correlated in patients with a positive scan within 2 h.


CONCLUSIONS
The (99m)Tc RBC scan is a sensitive, albeit non-specific, method for detecting GI bleeding. The location of a lesion as indicated by a positive scan within 2 h is helpful for guiding surgical intervention and angiography, although a definitive diagnosis should be made with other methods, particularly laparotomy.
Lee
Jung
J
Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung Children's Hospital, Taoyuan, Taiwan.
Lai
Ming-Wei
MW
Chen
Chien-Chang
CC
Chen
Shih-Yen
SY
Chao
Hsun-Chin
HC
Chan
Sheng-Chieh
SC
Kong
Man-Shan
MS
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004912:Erythrocytes / Q000000981:diagnostic imaging*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007410:Intestinal Diseases / Q000000981:diagnostic imaging*; D008297:Male; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012189:Retrospective Studies