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A case of intermittent bleeding Meckel's diverticulum.

T Imaeda1, M Kanematsu, Y Sone

  • 1Department of Radiology, University of Gifu School of Medicine, Japan.

Annals of Nuclear Medicine
|November 1, 1990
PubMed
Summary

Repeated technetium-99m pertechnetate scintigraphy is crucial for diagnosing Meckel's diverticulum. This imaging technique successfully identified ectopic gastric mucosa in a pediatric patient, confirming the diagnosis.

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Area of Science:

  • Nuclear medicine
  • Pediatric surgery
  • Gastroenterology

Background:

  • Meckel's diverticulum is a common congenital anomaly that can cause gastrointestinal bleeding.
  • Ectopic gastric mucosa within the diverticulum is often the source of bleeding.
  • Technetium-99m pertechnetate scintigraphy is a standard imaging modality for diagnosing Meckel's diverticulum.

Observation:

  • Initial technetium-99m pertechnetate scintigraphy showed equivocal or normal results.
  • A repeat scintigraphy, performed without pentagastrin stimulation, revealed a focal area of increased radioactivity in the right lower quadrant.
  • Surgical exploration confirmed Meckel's diverticulum containing ectopic gastric mucosa.

Findings:

  • The repeat scintigraphy successfully identified the bleeding Meckel's diverticulum.

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  • Histological examination confirmed the presence of ectopic gastric mucosa, the likely source of bleeding.
  • The reason for the initial imaging failure to detect the ectopic mucosa remains unclear.

    • Implications:

    • This case highlights the importance of considering repeat scintigraphy when initial results are inconclusive for Meckel's diverticulum.
    • The findings underscore the high prevalence of gastric mucosa in pediatric Meckel's diverticulum bleeding.
    • Accurate and timely diagnosis through scintigraphy is vital for appropriate surgical management and preventing complications.