The site of upper gastrointestinal bleeding, whether from the esophagus or stomach or duodenum, is determined by measuring radioactivity of the aspirate after intravenous injection of red blood cells tagged with radioactive chromium. A Necheles tube permits the sealing off of the esophageal aspirate from the gastric or duodenal aspirate. Of 15 patients tested, 6 were found to have hemorrhage from the stomach or duodenum, and 5 were bleeding from the esophagus. One patient with cirrhosis believed to be bleeding from esophageal varix was found to be bleeding from the duodenum (duodenal ulcer). The test was unsatisfactory in 4 patients because active bleeding had ceased.
Ariel IM. The Site of Upper Gastrointestinal Bleeding: Detection by Radioactive-Tagged Red Blood Cells. JAMA. 1962;180(3):212–214. doi:10.1001/jama.1962.03050160028007
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