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Potential False-Positive Meckel's Scan Caused by Umbilical Ornamentation
Ravishankar Pillenahalli Maheshwarappa1, Yusuf Menda
1From the Division of Nuclear Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA.
Clinical Nuclear Medicine
|July 24, 2020
Summary
A Tc-99m pertechnetate scan initially suggested Meckel's diverticulum in a patient with bloody stools. However, SPECT/CT revealed the uptake was due to umbilical inflammation, not a Meckel's diverticulum.
Area of Science:
- Nuclear medicine
- Gastroenterology
- Pediatric imaging
Background:
- Bloody stools in young adults can indicate various gastrointestinal issues, including Meckel's diverticulum.
- Tc-99m pertechnetate scintigraphy is a standard imaging modality for diagnosing Meckel's diverticulum.
Observation:
- An 18-year-old woman presented with bloody stools, prompting a Meckel's scan.
- Initial dynamic planar imaging showed increased uptake suggestive of Meckel's diverticulum.
- SPECT/CT localized the uptake to the periumbilical region.
Findings:
- The Tc-99m pertechnetate uptake was ultimately attributed to localized inflammation from umbilical ornamentation.
- This finding mimicked the typical appearance of Meckel's diverticulum on planar imaging.
- SPECT/CT provided crucial anatomical localization to differentiate the cause of uptake.
Implications:
- This case highlights the importance of SPECT/CT in nuclear medicine for precise localization.
- It demonstrates a rare differential diagnosis for abnormal Tc-99m pertechnetate uptake in the abdomen.
- Understanding potential mimics is crucial for accurate diagnosis in gastrointestinal bleeding evaluations.
