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A Potential Error in the Quantitation of Fecal Blood Loss: Concise Communication

Veterans Administration Hospital and University of California Medical Center, San Diego, California

Correspondence: For reprints contact: Andrew Taylor, Jr., Nuclear Medicine Div., Veterans Administration Hospital, 3350 La Jolla Village Dr., San Diego, CA 92161.

ABSTRACT

Chromium-51-labeled red cells were used to quantitate fecal blood loss in a patient with chronic upper gastrointestinal hemorrhage. On Day 1, the stool guaiac was positive but the blood loss indicated by ⁵¹Cr was less than 1 cm³. Blood loss in the stool by ⁵¹Cr did not become significant until Day 3, when it measured 23 cm³. The failure to detect abnormal blood loss on Day 1, and probably on Day 2, appears to be due to a long intestinal transit time from a proximal bleeding site. The problem of slow intestinal transit is not uncommon and could lead to a false-negative study or falsely low estimates of fecal blood loss. This problem could be minimized by beginning stool collection on Day 3 or by delaying stool collection until the appearance in the stool of an oral nonabsorbable marker swallowed when the ⁵¹Cr-tagged red cells are injected.