False positive GI bleed on Tc-99m RBC scintigraphy due to ileal varices.
Tc-99m labeled RBC scintigraphy is commonly employed in the evaluation of acute gastrointestinal bleeding. On Tc-99m RBC studies gastrointestinal bleeding is seen as an initial focus of increased radiotracer activity that on subsequent images increases in intensity and changes position in a pattern that conforms to segments of bowel. We report a case of a patient with multiple episodes of hematochezia that presented with lower gastrointestinal hemorrhage. A Tc-99m labeled RBC scan was performed and the findings suggested a GI bleed. However, subsequent angiography revealed prominent ileal varices simulating an acute bleed. Although most varices fill promptly and should not be misinterpreted as a focus of hemorrhage, slow filling varices can simulate an acute bleed and lead to a false positive interpretation.
Department of Radiology, University of Michigan Hospital, Ann Arbor, MI, USA.
Paul Ning-Chuan
PN
Chen
Richard Kevin
RK
Brown
D000369:Aged, 80 and over; D000792:Angiography; D003097:Collateral Circulation; D003106:Colon / Q000098:blood supply; D003951:Diagnostic Errors; D004912:Erythrocytes; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging*; D006801:Humans; D007082:Ileum / Q000098:blood supply*; D008642:Mesenteric Veins / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013667:Technetium; D014463:Ultrasonography; D014648:Varicose Veins / Q000000981:diagnostic imaging*
D019275:Radiopharmaceuticals; D013667:Technetium