Significance of scintigraphy for the localisation of obscure gastrointestinal bleedings

World J Gastroenterol. 2008 Aug 28;14(32):5015-9. doi: 10.3748/wjg.14.5015.


Aim: To determine the role of scintigraphy in patients with gastrointestinal (GI) bleeding of unknown localisation.

Methods: We performed retrospective analyses on 92 patients receiving scintigraphies from 1993 to 2000 in the University of Regensburg hospital, which were done for localisation of GI bleeding as a diagnostic step after an unsuccessful endoscopy. In addition to the scintigraphies, further diagnostic steps such as endoscopy, angiography or operations were performed. In some of the scintigraphies with negative results, a provocation test for bleeding with heparinisation was carried out.

Results: 73% of all scintigraphies showed a positive result. In 4.5% of the positive results, the source was located in the stomach, in 37% the source was the small bowel, in 25% the source was the right colon, in 4.5% the source was the left colon, and in 20% no clear localisation was possible. Only 4% of all scintigraphies were false positive. A reliable positive scintigraphy was independent of the age of the examined patient. A provocation test for bleeding with heparin resulted in an additional 46% of positive scintigraphies with a reliable localisation in primary negative scintigraphies.

Conclusion: Our results show that scintigraphy and scintigraphy with heparin provocation tests are reliable procedures. They enable a reliable localisation in about half of the obscure GI-bleeding cases. Scintigraphy is superior to angiography in locating a bleeding. It is shown that even in the age of video capsule endoscopy and double-balloon enteroscopy, scintigraphy provides a reliable and directed localization of GI bleeding and offers carefully targeted guidance for other procedures.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography
  • Colonography, Computed Tomographic
  • Female
  • Gastrointestinal Hemorrhage / diagnostic imaging*
  • Gastrointestinal Tract / diagnostic imaging*
  • Humans
  • Male
  • Middle Aged
  • Radionuclide Imaging*
  • Retrospective Studies
  • Technetium


  • Technetium