111Indium-labelled red-cell scintigraphy to detect intermittent gastrointestinal bleeding from synchronous small- and large-bowel adenocarcinomas

Damian J. Mole*, Simon J. Hughes, Kourosh Khosraviani

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

A 70-year-old woman presented with symptoms of profound anaemia and evidence of intermittent gastrointestinal haemorrhage. Oesophagogastroduodenoscopy, colonoscopy, abdominal computerised tomography, sulphur colloid scintigraphy and selective mesenteric angiography were non-diagnostic. An 111indium-labelled red-cell scan was performed, which suggested bleeding from the ileum at 36 h. At laparotomy, a primary small-bowel adenocarcinoma was resected. Six weeks later, she was again anaemic. Repeat colonoscopy showed a synchronous primary colonie adenocarcinoma, which had been masked by intraluminal blood during the original 111indium scan. The lesion was impalpable, even after full mobilisation of the colon. A right hemicolectomy was performed. 111Indium has a longer half-life (67 h) than the more commonly used 99mtechnetium isotope (18 h). This allows serial imaging for up to 5 days, which may increase diagnostic efficiency in intermittent gastrointestinal bleeding. Clinicians should be aware that persisting activity from intraluminal blood may mask synchronous lesions.

Original languageEnglish
Pages (from-to)795-799
Number of pages5
JournalEuropean Journal of Gastroenterology and Hepatology
Volume16
Issue number8
DOIs
Publication statusPublished - 1 Aug 2004

Keywords

  • Gastrointestinal haemorrhage
  • Ileal neoplasms
  • Indium radioisotopes
  • Neoplasms
  • Radionuclide imaging
  • Second primary

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