Diagnosis of midgut malrotation with 99mTc-pertechnetate abdominal imaging

In a six-year-old girl with recurrent abdominal pain, abdominal imaging with technetium-99m pertechnetate was performed to detect ectopic gastric mucosa in a Meckel's diverticulum but was negative in this respect. The pattern of radioactivity, moving from the stomach to the proximal small bowel, showed abnormal localization and high concentration of the radionuclide to the right of the midline, indicating midgut malrotation and obstruction. This was subsequently confirmed at exploratory laparotomy.