Life-Threatening Hemorrhage of an Unanticipated Superficial Circumflex Iliac Artery Origin Imaged With Tc-99m–Labeled Erythrocytes

The authors report, for the first time, the nuclear medicine diagnosis of extraperitoneal bleeding that originated from the superficial circumflex iliac artery and review the critical role of dynamic nuclear imaging techniques in the localization of sites of nonenteric hemorrhage. Dynamic imaging techniques using Tc-99m– labeled erythrocytes played a critical role in the localization of an extraperitoneal bleeding site near the entrance site of a Jackson–Pratt drain. Localization of the site remained undiagnosed before nuclear imaging despite two exploratory laparotomies and diagnostic angiography.