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.