Clinics in diagnostic imaging (162). Meckel's diverticulum

Area of Science:

• Gastroenterology
• Diagnostic Imaging
• Surgical Pathology

Background:

• Meckel's diverticulum is a congenital anomaly of the small intestine, often asymptomatic but can cause significant complications.
• Acute bleeding per rectum is a potential, though less common, presentation of Meckel's diverticulum.

Observation:

• A 28-year-old male presented with acute rectal bleeding.
• Computed tomography revealed a posterior ileal outpouching with hyperemic walls, but no active extravasation.
• Technetium-99m pertechnetate scintigraphy demonstrated abnormal focal uptake in the pelvis, correlating with gastric uptake patterns.

Findings:

• Surgical confirmation established the diagnosis of Meckel's diverticulum.
• The lesion was successfully resected, resolving the patient's symptoms.

Implications:

• This case highlights the utility of Technetium-99m pertechnetate scintigraphy in diagnosing Meckel's diverticulum, especially in cases of obscure gastrointestinal bleeding.
• Understanding the diverse clinical and imaging presentations is vital for accurate and timely diagnosis of Meckel's diverticulum.