Ectopic "Ectopic" Gastric Mucosa

Area of Science:

• Gastroenterology
• Diagnostic Imaging
• Pediatric Surgery

Background:

• Meckel's diverticulum is the most common congenital anomaly of the small intestine, arising from the omphalomesenteric duct.
• Ectopic gastric mucosa is found in approximately half of Meckel's diverticulum cases, often leading to complications.
• Conventional imaging modalities like radiography and sonography have limited diagnostic value for Meckel's diverticulum.

Purpose of the Study:

• To report a rare case of Meckel's diverticulum with ectopic gastric mucosa presenting with an atypical location on Tc-99 scintigraphy.
• To increase radiologist awareness of unusual imaging findings for Meckel's diverticulum.
• To emphasize the importance of considering atypical presentations in diagnosing gastrointestinal anomalies.

Main Methods:

• Review of a case involving Tc-99 pertechnetate scintigraphy for suspected Meckel's diverticulum.
• Correlation of imaging findings with surgical confirmation.
• Literature review for similar atypical presentations of Meckel's diverticulum.

Main Results:

• Tc-99 scintigraphy revealed ectopic gastric mucosal uptake in the upper mid abdomen, an atypical location.
• Surgical exploration confirmed Meckel's diverticulum located in the mid ileum.
• This represents a rare instance of an ectopic Meckel's diverticulum with unusual scintigraphic localization.

Conclusions:

• Atypical presentations of Meckel's diverticulum, particularly with ectopic gastric mucosa, can occur.
• Radiologists should be aware of unusual Tc-99 scintigraphy findings to ensure timely diagnosis and management.
• Familiarity with rare imaging patterns aids in the diagnosis of common congenital GI anomalies.