Name of the Procedure:

Acute Gastrointestinal Blood Loss Imaging (GI Bleeding Scan, Radionuclide Scanning, Nuclear Medicine GI Bleeding Scan)

Summary

Acute gastrointestinal blood loss imaging is a medical procedure used to identify the source of bleeding in the gastrointestinal (GI) tract. It uses specialized imaging technology to detect active bleeding and help doctors determine the best course of treatment.

Purpose

The procedure addresses acute gastrointestinal bleeding, which can be life-threatening and requires prompt diagnosis. The primary goal is to locate the exact site of bleeding in the GI tract to guide further treatment and management.

Indications

• Unexplained drop in blood pressure or hemoglobin levels
• Visible blood in vomit or stool
• Severe abdominal pain
• Patients with a history of GI diseases prone to bleeding, such as ulcers or diverticulosis
• Unsuccessful identification of bleeding source through endoscopy or colonoscopy

Preparation

• Fasting for at least 4-6 hours before the procedure
• Review of current medications, with potential adjustments, particularly blood thinners
• Pre-procedure blood tests to check for anemia and coagulation status

Procedure Description

1. A small amount of the patient's blood is drawn.
2. The blood is mixed with a radioactive tracer and re-injected into the patient.
3. The patient lies on an imaging table, and a gamma camera detects the radioactive tracer as it travels through the GI tract.
4. Continuous imaging is performed to see if and where the tracer accumulates, indicating a bleeding site.
5. The process may take several hours, depending on the rate and location of bleeding.

Duration

Typically ranges from 2 to 4 hours, though it may extend depending on the time required to detect active bleeding.

Setting

Performed in a hospital radiology or nuclear medicine department.

Personnel

• Nuclear medicine physician or radiologist
• Trained nuclear medicine technologist
• Nursing staff for patient care and monitoring

Risks and Complications

• Exposure to a small amount of radiation
• Potential allergic reaction to the radioactive tracer (rare)
• Possible discomfort from intravenous injection
• Temporary bruising or infection at the injection site

Benefits

• Accurate identification of the bleeding source within the GI tract
• Non-invasive compared to surgical exploration
• Helps in planning effective treatment, reducing hospital stay and recovery time

Recovery

• Minimal recovery time; patients can usually go home the same day
• Drink plenty of fluids to help flush the radioactive tracer from the body
• Follow-up appointments for discussing results and further treatment if necessary
• Patients are advised to avoid close contact with young children and pregnant women for a short period due to the residual radioactivity

Alternatives

• Endoscopy (upper or lower), which provides direct visualization but may not always identify slow bleeds
• Angiography to locate and treat bleeding, more invasive with higher risk
• CT angiography for locating the bleeding source non-invasively, though with limited sensitivity for slow bleeding

Patient Experience

• Mild discomfort during blood draw and intravenous injection
• Lying still for extended periods during imaging
• Low risk of discomfort from exposure to the radioactive tracer
• Pain management involves minimizing movement and providing support during the imaging process