Detection of the bleeding source from small intestine: intraoperative endoscopy and preoperative abdominal scintigraphy by technetium 99m pertechnetate.

Bleeding ulcerative lesions of the small intestine often present difficult diagnostic problems. Useful techniques to establish a diagnosis include abdominal scintigraphy using technetium 99-m pertechnetate and intraoperative endoscopic examination of the intestine. Our experience with these techniques is based on 25 patients who were treated in 1974-1983. In 18 adults, the diagnoses included Crohn's disease, non-specific ulcers and intestinal tuberculosis. In 6 of the 18 adults, the source of bleeding was difficult to determine during laparotomy and diagnosis was established by intraoperative endoscopic examination. In the seven children, the diagnoses included ectopic gastric mucosa and lymphoid hyperplasia. In the children, abdominal scintigraphy was used as a preoperative measure to detect the bleeding source.