The patient is a 20 year-old male with a history of GI bleeds of unknown origin, and decreasing hematocrit referred to evaluate for source of GI bleeding.
On the immediate images from 0 to 60 minutes, normal tracer activity is seen in the blood pool of the abdominal aorta, common iliac arteries, femoral arteries, liver, spleen and genitalia on all of the interval images. No evidence for abnormal tracer uptake is noted ectopic to the blood pool that would be consistent with an active GI bleed.
On the delayed images 15 hours later, tracer is identified in blood clots in the small bowel. Three clots are stationary, and the fourth is in transit, likely due to peristalsis, during the one-hour observation period. It is less likely that the fourth site represents an active bleeding source. All four sites are located in the small bowel in the right upper quadrant of the abdomen.
During the initial 1 hr observation period, there is no evidence for an active gastrointestinal bleed.
In the delayed images at 15 hours, the site of GI bleed is localized to the small bowel in the right upper quadrant. It is not possible to state whether at this time the bleeding is ongoing.