RESUMO
Background@#Lower Gastrointestinal bleeding (LGIB) is a serious and urgent condition which can be assessed using several different modalities. Tc-99m tagged RBC scintigraphy has been established as a diagnostic tool in Nuclear Medicine but several other modalities, including CT-based imaging (i.e. angiography) currently exist. @*Objective@#The objective of this study is to compare Tc-99m tagged RBC scintigraphy with CT-based imaging studies in terms of clinical utility and diagnostic outcomes. @*Methods@#A systematic review of available literature was done, with the goal of creating a meta-analysis focusing on the reported diagnostic outcomes - mainly sensitivity and specificity on the presence of a LGIB. Aside from this, a systematic review of the clinical utility and the differences of each test were discussed, including non-quantifiable advantages. The literature search was conducted following the guidelines of PRISMA, with searches from PubMed, Medline, and other pertinent databases. Quality assurance was done using the QUADAS tool. Statistical analyses of sensitivity, specificity, and a summary receiver operating characteristics plot were computed for the meta-analysis.@*Results@#Pooled sensitivity and specificity for RBC scintigraphy were 0.886 and 0.119, respectively. Pooled sensitivity and specificity for CT-based imaging were 0.729 and 0.660, respectively. CT based imaging also showed higher localization and faster completion times. RBC scintigraphy had a longer acquisition window.@*Conclusion@#Both Tc99m-tagged RBC scintigraphy and CT-based imaging have important clinical utility, with each modality having different advantages that the other test cannot provide.
Assuntos
Angiografia por Tomografia ComputadorizadaRESUMO
Ulcerative colitis is a chronic inflammatory disease of unknown etiology. It is localized to the colon and spares the upper gastrointestinal tract. Ulcerative colitis can occur at any age, the peak incidence is among the age group 15-25 years and in 55-65 years. The first pediatric case was reported by Helmholz. The purpose of reporting this case of 17 year old girl with ulcerative colitis who presented with severe anemia is, to not only create awareness of ulcerative colitis among pediatric age group but also to discuss the challenges facing the diagnosis and management of the disease in a developing country like India.
RESUMO
A retrospective analysis of the clinical profile, endoscopic features and management of 22 children (age 18 months – 18 years) diagnosed as solitary rectal ulcer syndrome is presented. The majority (81.8%) were ≥8 years of age. Rectal bleeding was the presenting feature in all the children. Mucorrhea, constipation, tenesmus and rectal prolapse were observed in 77.3%, 63.6%, 59% and 13.6% children, respectively. Colonoscopy showed classical single rectal ulcer in 68.2% and multiple ulcers in 22.7%. Polypoidal and erosive lesions were documented in 4.5% each. The medical management comprised of bowel training and high fibre diet for all children. The other modalities included oral 5-amino salicylate (59%), sucralfate enema (4.5%) and rectal mesalamine in 9%. 64% children recovered and 13.6 % had recurrence of symptoms.