TAILIEUCHUNG - Society of Nuclear Medicine Procedure Guideline for Gastrointestinal Bleeding and Meckel’s Diverticulum Scintigraphy

Recognizing the redistributive nature of investment in TM is important. Indigenous people will seek the help of tradi- tional healers because of proximity, familiarity, and trust. Investments in TM could therefore be used strategically to increase access to conventional preventive and therapeutic care. Including the traditional healer as part of the health care team may thus be an important strategy both to attract patients and to upgrade the skills and training of traditional healers. How equity is affected by the proportions in which different condition-specific interventions are combined and how other interventions (regulations, tax policy, managerial changes) are likely to affect equity need to be studied. Given that the major- ity of indigenous. | Society of Nuclear Medicine Procedure Guideline for Gastrointestinal Bleeding and Meckel s Diverticulum Scintigraphy version approved February 7 1999 Authors Patrick V. Ford MD St. Luke s Episcopal Hospital Houston TX Stephen P. Bartold MD Texas Tech University Odessa TX Darlene M. Fink-Bennett MD William Beaumont Hospital Royal Oak MI Paul R. Jolles MD Medical College of Virginia Richmond VA Robert J. Lull MD San Francisco General Hospital San Francisco CA Alan H. Maurer MD Temple University Hospital Philadelphia PA James E. Seabold MD University of Iowa Hospitals and Clinics Iowa City IA . I. Purpose The purpose of this guideline is to assist nuclear medicine practitioners in recommending performing interpreting and reporting the results of gastrointestinal bleeding and Meckel s diverticulum scintigraphy. II. Background Information and Definitions Gastrointestinal bleeding scintigraphy is performed in patients suspected of active gastrointestinal bleeding using Tc-99m labeled red blood cells RBCs . Sites of active bleeding are identified by the accumulation and movement of labeled Red Blood Cells within the bowel lumen. Since activity within the lumen of the bowel can move antegrade and retrograde frequent images 1 image every 10-60 sec will increase the accuracy of localizing the bleeding site. Tc-99m sulfur colloid SC is rarely used today because of the short residence time within the blood. Tc-99m SC is cleared from the blood by the reticuloendothelial system with a half-time as short as 2 to 3 min while radiolabeled RBCs last for hours. Gastrointestinal bleeding GI is either upper originating above the ligament of Treitz or lower distal to the ligament of Treitz. Frequent causes of upper GI bleeding include esophageal varices gastric and duodenal ulcers gastritis esophagitis Mallory-Weiss tear or neoplasm. Causes of lower GI hemorrhage include angiodysplasia diverticula neoplasms and inflammation and in children Meckel s diverticulum. Endoscopy and .

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