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Sodium pertechnetate scintigraphy in detection of Meckel's diverticulum: is it usable?
1Department of Surgery, Odense University Hospital, Denmark.
Objective:
To evaluate the results of 99mTc-Na-pertechnetate scintigraphy in children presenting with symptoms suspicious of Meckel's diverticulum (MD).
Method:
Retrospective study. A total of 55 99mTc-Na-pertechnetate scintigraphies in 53 patients were compared with the results from surgery and other diagnostic procedures and available section reports during the period from 1 Jan. 1981 to 1 Jan. 1996.
Results:
There were four positive scintigraphies. Three patients underwent a laparotomy and an MD was found. The fourth patient was not operated on and no rebleeding was seen after an observation period of 4 years. A total of 51 scintigraphies were negative. In this group two cases with an MD were found at a later laparotomy for other reasons. We found a sensitivity of 60% on 99mTc-Na-pertechnetate scintigraphy in the detection of MD, a specificity and accuracy of 98% and 87%, respectively.
Conclusion:
The 99mTc-Na-pertechnetate scintigraphy has only minor diagnostic value in diagnosing patients suspected of having an MD. Scintigraphic examination should be replaced by diagnostic laparoscopy, which has been reported to be safe and effective and offers the possibility of laparoscopic resection of the MD.