Giá trị của chụp xạ hình với Tc-99m gắn hồng cầu trong chẩn đoán chảy máu ruột non

Objective: To evaluate the diagnostic value of Tc 99m-labeled red blood cell scintigraphy for diagnosis of small bowel bleeding. Subject and method: The study included 43 patients with GI bleeding that causes were suspicious from small bowel, treated at 108 Military Central Hospital and Bach Mai Hospital. Clinical presentation was black stool without any evidence found on gastroduonoscopy and colonoscopy. All patients underwent scintigraphy using Tc 99m-labeled red blood cell, and then enteroscopy to confirm the diagnosis and find out the aetiology of bleeding. Result: Mean age was 49.3 +/- 5.8, male accounted for 65.1 percent. History of drinking alcohol was seen in 27.9 percent of patients and NSAIDs users were 18.5 percent.48.8 percent of patients had no risk factors. The most common clinical symptoms were black stool (100 percent), tarchycardia (100 percent) and pale skin (69.8 percent). The aetiologies of bleeding found on enteroscopy were: Ucer (51.2 percent), benign polyps (27.9 percent), angiodysplasia (11.6 percent), Dieulafoys lesion (4.6 percent), and Meckels diverticulum (4.6 percent). The sensitivity of scintigraphy using Tc-99m in diagnosis of small bowel bleeding was 76.7 percent. The sensitivity of scintigraphy according to the aetiology of small bowel bleeding as ulcer, polyp, Dieulafoys lesion, angiodysplasia and Meckels diverticulum were 81.8 percent; 83.3 percent; 50 percent; 60 percent and 100 percent, respectively. Conclusion: Tc 99m-labeled red blood cell scintigraphy is a valuable tool for diagnosis of small bowel bleeding.