A 52-year-old Caucasian woman presents with a 2-week history of rectal bleeding. Over the last 3 months, she has become progressively more tired, and could no longer play tennis on weekends. She denies diarrhea, abdominal pain or tenesmus. Her past medical history includes peptic ulcer disease 5 years ago, treated with an anti-H.pylori scheme and which has not recurred.
Her vital signs are stable, and the physical examination shows no abnormalities.
A CBC shows the following:
Ht: 28%
Hb: 8.8 mg/dl
MCV: 82 fl
Leukocytes: 8.100/mm3 w/ normal differential
An upper endoscopy is normal except for a duodenal ulcer scar without signs of active ulceration, and a repeat colonoscopy is normal.
What is most likely to identify the source of bleeding?
A) Celiac angiography
B) Computed tomography of the abdomen
C) Wireless capsule endoscopy
D) Push enteroscopy
E) Biopsy of the healed ulcer bed
F) 99mTc scan
G) Small bowel follow-through99mTc scan
