Abstract
AbstractA retrospective analysis of angiography for the investigation of lower gastrointestinal bleeding (LGIB) was conducted at our institution, exploring the factors affecting diagnostic yield and the correlation with nuclear medicine 99 mTc red blood cell (RBC) scintigraphy. During a five‐year period (March 2003 to March 2008), 44 patients were investigated using angiography alone with 15 (34%) positive for LGIB. Within the same period 159, 99 mTc RBC scans were performed with 65 (41%) examinations positive for LGIB. Of these 159 patients, 45 proceeded to angiography within a 24‐hour period with 19 (42%) demonstrating active bleeding. Importantly, 10 patients proceeded to angiography despite a negative RBC scan and none recorded a positive angiogram. Also, 19 of 35 (54%) patients demonstrated active bleeding on angiography following a positive RBC scan. The average time between nuclear medicine and angiography was 5.83 hours (range 0.63–21.5 hours). The study was limited to patients demonstrating active, immediate bleeding on RBC scintigraphy, and when performed within 5 hours following, the diagnostic yield of angiography increased from 34% to 89%. Careful adherence to such criteria will in future increase diagnostic confidence for clinical management of LGIB while reducing the number of unnecessary angiographic investigations.
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