Role of Nuclear Medicine Bleeding Scan

Unlike the upper GI tract where a nuclear medicine study is generally not helpful, a 99mTechnetium (99mTc) - labeled "tagged" red blood cell (RBC) study may be useful in helping to localize a bleeding site in the lower GI tract. One of the advantages of a 99mTc - labeled RBC study is that the patient may be scanned at intervals, thereby increasing the likelihood of detecting the bleeding site. A "single pass" Technetium-labeled sulfur colloid radionuclide study may be useful if the patient is actively bleeding but interval scanning is not possible. In those patients who are debilitated with renal insufficiency, assistance in localizing the bleeding site is useful so that the angiographic exam may be "tai lored" and the quantity of contrast reduced. Colonoscopy likewise may prove useful but often patients with a lower GI hemorrhage present emergently and the colon is not clean (ie, prepped). The nuclear medicine "bleeding scan" is more sensitive than angiography in detecting lower GI tract hemorrhage, but less anatomically specific. It is generally stated that the nuclear medicine scan (in ideal situations) will detect a lower GI bleed rate as low as 0.1 cc/min; whereas angiography requires a bleeding rate of 1 cc/min (ie, IDX greater). There is a separate chapter on lower GI bleeding (see Chapter 101).

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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