The sodium pertechnetate Tc 99m scan: an aid in the evaluation of gastrointestinal bleeding

Twenty pediatric patients presenting primarily with unexplained gastrointestinal bleeding were evaluated with sodium pertechnetate Tc 99m imaging. Three patients had normal barium enemas and scans consistent with Meckel's diverticulum. These three patients and three additional patients with normal scans underwent surgical exploration. Meckel's diverticula containing gastric mucosa were found in all three patients with positive scans. No diverticula were found in the three patients with normal scans. Four other patients had scans that were considered abnormal but not felt to represent Meckel's diverticula. In one of these patients a radiographic gastrointestinent, a nonspecific terminal ilial ulcer without gastric mucosa was found at surgery. The two other patients had normal radiographic gastrointestinal studies and no further evaluation was carried out. The etiology of gastrointestinal bleeding in pediatric patients is frequently unexplained even after thorough evaluation including celiotomy. The sodium pertechnetate Tc 99m scan is a safe, simple, non-invasive procedure that can demonstrate Meckel's diverticula with greater certainty than the barium enema and can suggest suspicious areas that can then be evaluated by more definitive procedures.