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Indium-111-Leukocyte Imaging: A Case of Peritonitis Mimicking Inflammatory Bowel Disease

Departments of Radiology and Surgery, Creighton University Medical Center, and Department of Radiology, University of Nebraska Medical Center, Omaha, Nebraska

Correspondence: For correspondence or reprints contact: Lisa Suzanne Gobar, MD, Department of Radiology, Creighton University School of Medicine, 601 N. 30th St., Omaha, NE 68131.

ABSTRACT

Leukocytes labeled with ^99mTc-HMPAO and ¹¹¹In have been used extensively in imaging inflammatory disorders, including inflammatory bowel disease (IBD), which has the appearance of tubular bowel activity. Peritonitis is inflammation of the serosal surfaces lining the peritoneal cavity which envelopes the bowel, giving a pattern of diffuse abdominal uptake on imaging. We present a case of an elderly man with surgically and pathologically confirmed peritonitis whose preoperative leukocyte scan mimicked the findings of IBD. Our findings suggest that diffuse peritonitis can mimic IBD on an ¹¹¹In-leukocytescan.

Key Words: peritonitis • indium-111 leukocyte • inflammatory bowel disease • splenectomy