[TC-99m-pertechnetate scintigraphy in the diagnosis of abdominal diseases]. / La scintigrafia con TC-99m-pertecnetato nella diagnostica della patologia endoaddominale.

OBJECTIVE: To show the possible role of abdominal scintigraphy in the diagnosis of intra-abdominal pathology and its accuracy in detecting ectopic gastric mucosa in pts with intestinal bleeding and/or abdominal pain. METHOD: 99m-Tc-pertechnetate scintigraphy was performed on 54 pts with a history of intestinal bleeding and/or abdominal pain with the following results: 11 true positive pts (9 with Meckel's D; 2 with enteric duplication) all of whom were confirmed at surgery; 14 false positive pts in whom the presence and location of entero-colic (12 pts), renal (2 pts), and uterine (1 pt) pathology were determined; 28 true negative pts; an arca of persistent low activity was found in the bladder of 1 pt which later proved to be a ureterocele at ultrasound; 1 false negative pt who was found to have Meckel's D at surgery. CONCLUSION: In this case series abdominal scintigraphy was effective in diagnosing 26/54 pts and, in particular, in diagnosis, 23/28 pts in recurrent intestinal bleeding. Given that its sensitivity is not negligible and that it is an exam which is scarcely invasive, easy to perform and interpret and requires low irradiation (definitely lower than barium enemas, digestive tract radiography and CT), abdominal scintigraphy should be the first examination to be performed in all pts with intestinal bleeding and/or abdominal pain, especially children, whose diagnosis cannot be simply or rapidly determined.

Hyperventilation and ergonovine tests in Prinzmetal's variant angina: comparative sensitivity and relation with the activity of the disease.

Hyperventilation (HV) and ergonovine (E) tests were carried out in a group of 32 patients with variant angina to compare their sensitivity and to correlate the results with the activity of the disease. The HV test was positive in 84% of the patients and E in 94% of them; the percentage of positive responses to HV was similar to that to E (96% vs 100%) in the patients with daily attacks, while it was lower (55% vs 77%) in those with sporadic attacks. All 27 patients with a positive HV also had a positive response to E, while of the five patients with a negative HV, two also had a negative response to E and the other three had a positive E at a higher dose than that of the patients with daily attacks. The incidence of chest pain and of ST-segment elevation or depression or T-wave positivization was similar during the two tests; however, spontaneous remission of ischaemia was more frequent after HV than after E and ventricular arrhythmias less frequent during the HV test. At the onset of myocardial ischaemia pH was significantly higher compared with basal values (7.51 +/- 0.07 vs 7.38 +/- 0.05, P less than 0.001), while double product was not significantly different compared with basal (10.0 +/- 2.4 vs 9.2 +/- 2.1).(ABSTRACT TRUNCATED AT 250 WORDS)