Incidental Detection of Gastrointestinal Bleeding From an Aortoenteric Fistula on 99mTc Leukocyte Scintigraphy

Abstract

A 50-year-old-man with abdominal pain, who had undergone aortic aneurysm reconstructive surgery (aortic graft) 3 years before, was admitted to the hospital. A CT scan showed findings suggestive of perigraft infection. Scintigraphy with 99mTc-hexamethylpropylene amine oxime (HMPAO)-labeled leukocytes confirmed the diagnosis of aortic graft infection and documented an active concurrent bleeding in the gastrointestinal tract from a secondary aortoenteric fistula. This case illustrates the diagnosis of the precise location of the source of bleeding from aortoenteric fistula by leukocyte scintigraphy. The images aided the surgical team by revealing the aortic site of bleeding and the severity of the problem.