Terminal ileal micro-perforation from an ingested fish bone incidentally diagnosed with 111In-leukocyte scintigraphy in an asymptomatic patient

Radiology Case Reports

Leonie Gordon, MBChB¹  William J. Rieter, MD, PhD²  Connor D. Crowley, MD³ 

[1] Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC 29425;Corresponding author at: Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas Street, MSC 323, Suite 210 CSB, Charleston, SC 29425.;Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC 29425;

关键词: Indium-111;    Leukocytes;    White blood cells;    Fish bone;    Perforation;    SPECT/CT;   

DOI  :  

来源: DOAJ

【 摘 要 】

111In-leukocyte scintigraphy has generally been considered a sensitive diagnostic test for the evaluation of infectious or inflammatory processes in the abdomen due to a lack of normal physiologic bowel activity. Herein we present a case of a patient status post endovascular repair of an abdominal aortic aneurysm for which an 111In-leukocyte scan was ordered to assess for graft infection. Planar imaging revealed an abnormal focus of radiotracer activity in the right lower quadrant of the abdomen. A SPECT-CT obtained to further delineate the anatomic location of abnormal activity showed abnormal leukocyte activity localizing to the terminal ileum secondary to a micro-perforation from an ingested fishbone. This case underscores the principle that in the absence of known intra-abdominal pathology, 111In-leukocyte activity in the abdomen should always be considered abnormal, and that further evaluation with dedicated cross-sectional imaging should be performed to assist with the localization of abnormal activity.

【 授权许可】

Unknown