Indian Journal of Nuclear Medicine
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Year : 2018  |  Volume : 33  |  Issue : 3  |  Page : 245-247

Umbilical varices: A potential pitfall in gastrointestinal bleed scintigraphy interpretation


Department of Nuclear Medicine and PET CT, Infocus Diagnostics, Ahmedabad, Gujarat, India

Correspondence Address:
Sunny J Gandhi
Infocus Diagnostics, 45-B, Swastik Society, Opp. Vipul Dudhiya, Navrangpura, Ahmedabad, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijnm.IJNM_28_18

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Tc-99m labeled red blood cell (RBC) scintigraphy is commonly used in the evaluation of acute gastrointestinal (GI) bleeding. On Tc-99m RBC studies, GI bleeding is seen as an initial focus of increased radiotracer activity that on subsequent images increases in intensity and changes position in a pattern that confirms to segments of bowel. We report a case of a patient with multiple episodes of GI bleeding referred to detect the source of bleeding. A Tc-99m labeled RBC scan was performed and the findings showed a focal abnormal hot spot in the mid quadrant of the abdomen, seen promptly in initial dynamic images. Subsequent static and single-photon emission computed tomography-CT (SPECT-CT) images found it to be umbilical varices. Most varices fill promptly as in this case and should not be misinterpreted as a focus of hemorrhage. SPECT-CT should be used in such cases so that that false-positive interpretation can be avoided.


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