A 73-year-old man who had two previously unsuccessful ileal resections for gastrointestinal bleeding thought to be due to multiple angiodysplastic lesions again presented with acute bleeding. Results of Tc-99m RBC scintigraphy were positive, but those of celiac angiography were negative. The patient underwent laparotomy with portable intraoperative Tc-99m RBC scintigraphy, showing localization of the bleeding site to a specific segment of jejunum, which was further confirmed by evacuation and repeated imaging. Resection of that segment of jejunum was further confirmed by evidence of a bleeding submucosal artery (Dieulafoy's disease). No further bleeding occurred during operation or afterward. Portable intraoperative Tc-99m scintigraphy should be considered in managing patients with problematic gastrointestinal bleeding.
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