The clinical significance of intestinal accumulation in non-gastroenteric scintigraphic studies

Learning Objectives 1. To provide an overview of unexpected intestinal uptake in scintigraphic studies. 2. To demonstrate specific cases with intestinal accumulation in non-gastrenteric scintigraphic studies. 3. To emphasize in the finding of enterovesical fistula and its significance in the evaluation of the patients.

Many scintigraphic studies are performed for the evaluation of gastrointestinal pathology, such as ectopic gastric mucosa, imaging of gastrointestinal bleeding, protein-losing enteropathy, inflammatory bowel disease, etc. Normally, intestinal uptake of many radiopharmaceuticals, i.e. Ga-67 citrate or F-18 FDG, is seen in the bowel. However, unexpected intestinal accumulation is also observed in other scintigraphic studies. We present 2 cases, where radiopharmaceutical uptake in the intestinal tract was observed in routine studies (bone scan and renogram) as well as another case where accumulation of the isotope was noted in the Sm-153 EDTMP post-treatment scintigraphy. In all cases an unknown enterovesical fistula, was verified. The identification and immediate reporting of this finding improved patients’ care and the outcome. We will also discuss other causes of intestinal accumulation