Clinical Indication: dark stools and drop in hematocrit in patient w/ history of AML status/post bone marrow transplant.
Dose: 25mCi Tc-99m as tagged RBC’s given i.v.
Results: study does not demonstrate extravasation to suggest gastrointestinal bleeding during 4 hr period of observation.
Clinical Indication: lower GI bleed w/ negative upper and lower endoscopy.
Dose: 25 mCi Tc-99m as tagged RBC’s given i.v.
Results: normal distribution of tagged red cells was identified - negative for active GI bleeding.
Clinical Indication: post vagotomy and pyloroplasty w/ nausea - solid phase gastric emptying study.
Dose: 1 mCi Tc-99m-labled albumin colloid.
Results: rate of emptying demonstrated by this study would be within normal limits for a patient who had not undergone any gastric surgery; however exact normals for patient status/post vagotomy and pyloroplasty are not readily available - there is no gross delay in emptying in this individual.
Clinical Indication: 34 y/o white female w/ nausea and vomiting.
Dose: 1 mCi Tc-99m-labeled albumin colloid in eggs.
Results: gastric emptying times are normal.
Clinical Indication: white female w/ chronic nausea, who has had a normal upper GI endoscopic study.
Dose: 1 mCi Tc-99m a.c.
Results: emptying rate is w/in normal limits.
Clinical Indication: 54 y/o white male w/ history of cirrhosis of liver - evaluate for gastroperisis.
Dose: 1 mCi Tc-99m labeled albumin colloid.
Results: normal gastric emptying study.
Clinical Indication: 42 year old white female w/ insulin-dependent diabetes mellitus; patient has had nausea, vomiting, and weight loss.
Dose: 1.0mCi Tc-99m A.C. - patient was given a dose of Regland previous evening.
Results: possible small hiatal hernia, finding consistent w/ gastroparesis.
Clinical Indication: 69 year old white male w/ history of lung cancer and insulin dependent diabetes; presently unable to keep food down w/ loss of appetite and vomiting.
Dose: 1.0mCi Tc-99m A.C.
Results: abnormally delayed gastric emptying with estimated half-emptying time of 160 minutes - normal range 55 - 110 minutes; emptying consistent with diabetic gastroparesis.
Clinical Indication: 73 year old male with one month history of nausea and vomiting.
Dose: 500uCi Tc-99m A.C.
Results: no evidence of mechanical obstruction, however patient was unable to tolerate the standardized meal.
Clinical Indication: patient has a history of abdominal pain and vomiting; recent endoscopy revealed anatomical abnormality of second portion of duodenum.
Dose: N/A
Results: markedly prolonged gastric half-emptying time.
Clinical Indication: 80 year female w/ GI bleed; tagged red cell study to assess origin of blood.
Dose: ragged RBC.
Results: 13 hour delay images show the presence of blood in what appears to be small bowel. the chief consideration would be primary small bowel bleed, although upper GI bleed w/ transit to the small bowel is a possibility - less likely would be a left sided colon bleed w/ retropulsion into the small bowel.
Clinical Indication: 66 year old black female w/ history of rectal bleeding; patient recently underwent a colonoscopy which demonstrated blood in the cecum/terminal ileum region.
Dose: 25 mCi Tc-99m labeled RBC’s given i.v. and 1mg glucagon given i.v.
Results: right lower quadrant localized area of radiotracer accumulation which is consistent with active bleeding; likely bleed site is cecum and distal terminal ileum or appendix are other, less likely, potential sites.
Clinical Indication: 19 year old black female who is s/p C-section; patient recently undergone interperitoneal blood loss and is requiring frequent transfusion.
Dose: 25 mCi Tc-99m as tagged RBC’s given i.v.
Results: radiotracer collection on the immediate images in the region of the uterus, which intensifies on the 5 min image, is consistent with active bleeding.
Clinical Indication: 64 year old white female w/ small cell cancer of lung s/p cycly chemo; has black stools and previous GI bleed.
Dose: 25mCi Tc-99m as tagged RBC’s and 1mg glucagon given i.v.
Results: initial images failed to localize a gastrointestinal bleeding site; delayed images confirmed that active gastrointestinal bleeding has taken place in the interim between the two image sets. Due to the large amount of blood present in the colon, it is not possible to accurately delineate the bleeding site, however, the cecum is perhaps the most suspicious area. Additional images were obtained at 15.5 and 17.5 hours, and these images failed to show any progressive increase in small bowel activity. However, there did appear to be a mild increase in the degree of activity seen in the right colon.
Clinical Indication: post nissen fundoplication w/ complaints suggesting delay in gastric emptying.
Dose: 1 mCi Tc-99m albumin colloid.
Results: study is compatible w/ gastroparesis. Reglan was administered after the 90 minute image; approximately 32% of the pre-Reglan counts are eliminated from the stomach during the first 1/2 hour following Reglan. Study suggests some acceleration of gastric emptying following Reglan; however, the gastric residuals do not normalize w/in 30 minutes following Reglan.