title: Importance of Heparin Provocation and SPECT/CT in Detecting Obscure Gastrointestinal Bleeding on 99mTc-RBC Scintigraphy: A Case Report.
abstract: We presented a pediatric case with a history of intermittent melena for 3 years because of angiodyplasia of small intestine. The results of frequent upper gastrointestinal endoscopies and colonoscopies as well as both Tc-red blood cell (RBC) and Meckel's scintigraphies for several times were negative in detection of bleeding site. However, Tc-RBC scintigraphy with single-photon emission computed tomography (SPECT)/computed tomography (CT) after heparin augmentation detected a site of bleeding in the distal ileum which later was confirmed during surgery with final diagnosis of angiodysplasia.It could be stated that heparin provocation of bleeding before Tc-RBC scintigraphy accompanied by fused SPECT/CT images should be kept in mind for management of intestinal bleeding especially in difficult cases.
authors: From the Nuclear Medicine and Molecular Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Mahdi
authors: M
authors: Haghighatafshar
authors: Farshid
authors: F
authors: Gheisari
authors: Tahereh
authors: T
authors: Ghaedian
mesh_terms: D000293:Adolescent; D016888:Angiodysplasia / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D000925:Anticoagulants; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D006493:Heparin; D006801:Humans; D007082:Ileum / Q000098:blood supply / Q000473:pathology / Q000601:surgery; D008551:Melena / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D011877:Radionuclide Imaging / Q000379:methods; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D006493:Heparin