Localization of upper GI bleed on delayed imaging with 99mTc tagged RBC angiogram.

Gastrointestinal bleeding is a frequently encountered clinical entity, the incidence of which has remained relatively constant at approximately 70 episodes per 100,000 population per year.1 Although the treatment of gastrointestinal bleeding is often straightforward, the identification and localization of the source of bleeding is more challenging. Due to intermittent nature of bleeding, detection efficiency depends upon the active bleeding during the diagnostic procedure like contrast angiography or nuclear medicine studies. Radionuclide imaging with tagged RBC study has an advantage of sequential imaging up to 24 hours after the injection and hence increases the detection efficiency without extra radiation exposure to the patient, at the same time being cost effective and non-invasive. We are presenting an interesting case of recurrent upper GI bleeding detected by sequential imaging with tagged RBCs.