HEMOBILIA PRESENTING AS INTERMITTENT GASTROINTESTINAL HEMORRHAGE WITHSINCALIDE CONFIRMATION - A CASE-REPORT

An 82-year-old man had his third episode of melanotic stool. Two previ ous workups had failed to localize the source of bleeding. A Tc-99m la beled RBC scan visualized the gallbladder early in the study. Administ ration of sincalide visually decreased the activity, confirming gallbl adder activity. Three months later, at his second surgery, hepatic met astases were finally identified as the source of bleeding. In retrospe ct, the hepatic activity is inhomogeneous with at least two cold defec ts that could have represented hepatic metastases.