Anterior images at two minute time intervals
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Full history/Diagnosis is available below
On this admission, the patient was again admitted again with blood per rectum, but appeared to have stopped bleeding the following day. Given the multiple negative prior exams and repeated hospitalizations, a decision was made to administer heparin during the current study, in a closely monitored setting.
Subsequent images (not shown) show progressive transit through small bowel to the cecum.
As in this case, anticoagulation may occasionally be useful in a patient with multiple bleeding events that otherwise elude diagnosis.
The patient then had resection of a small portion of the jejunum, and pathology revealed an arterio-venous malformation with a small overlying mucosal ulcer.
Bleeding is frequently intermittent.
Continued imaging after initial visualization of a bleeding focus with following of the blood through the bowel lumen may be needed to anatomically localize the bleeding site. While one is still imaging to help in localization of an observed active bleeding site, remember to check the patient's blood pressure and notify the patient's physician in case he/she wants to arrange for angiography.
References and General Discussion of Gastrointestinal Bleeding Scintigraphy (Anatomic field:Gasterointestinal System, Category:Organ specific)
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