Download PDF
CC BY-NC-ND 4.0 · World J Nucl Med 2020; 19(01): 52-55
DOI: 10.4103/wjnm.WJNM_27_19
Case Report

Unusual presentation of a curve-shaped Meckel's diverticulum detected on technetium-99m Meckel's scintigraphy

Dharmalingam Anitha
Department of Nuclear Medicine Surgery, Seth G.S Medical College and KEM Hospital, Parel, Mumbai, India
,
Pawar Shwetal
Department of Nuclear Medicine Surgery, Seth G.S Medical College and KEM Hospital, Parel, Mumbai, India
,
Shetye Suruchi
Department of Nuclear Medicine Surgery, Seth G.S Medical College and KEM Hospital, Parel, Mumbai, India
,
Ghorpade Mangala
Department of Nuclear Medicine Surgery, Seth G.S Medical College and KEM Hospital, Parel, Mumbai, India
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Complicated Meckel's diverticulum (MD) in pediatric age group may not present with classic symptoms or signs. The routine modalities of investigations for the detection of MD are ultrasonography (US), computerized tomography, and air enema. However, these may miss the diagnosis in cases of atypical patterns of presentation. In such situations, the radionuclide Meckel scan helps to narrow down the diagnosis. The objective of this case report was to present an unusual presentation of MD where the diagnosis was established by a radionuclide scan against other methods which were equivocal. An 8-year-old boy was admitted with features of intestinal obstruction.99mTc-pertechnetate Meckel's scintigraphy showed localization of tracer in ectopic gastric mucosa. The surgical exploration after the Meckel's scan revealed a curve-shaped MD localized 50 cm proximal to the ileocecal valve. The surgery was completed after a diverticulectomy, and the patient was relived of symptoms. MD scintigraphy can help detect ectopic gastric mucosa in cases of unusual presentation by considering the atypical presentation, variation in shape, and location on Meckel's scan and improve the disease management.

Keywords

Gastric mucosa - meckel's diverticulum - radionuclide Meckel's scan

Financial support and sponsorship

Nil.




Publication History

Received: 26 March 2019

Accepted: 29 June 2019

Article published online:
19 April 2022

© 2020. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Whang EE, Ashely SW, Zinner MJ. Schwartz's Principles of Surgery. 8th ed. New York: McGraw-Hill; 2005. p. 1043-4.
  • 2 Mckenzie S, Krantz SB. Sabiston Textbook of Surgery. 20th ed. Philadelphia: Elsevier; 2012. p. 1268-70.
  • 3 Prall RT, Bannon MP, Bharucha AE. Meckel's diverticulum causing intestinal obstruction. Am J Gastroenterol 2001;96:3426-7.
  • 4 Heldans F, Neff G. Das maxkelsche divertikel erbgeb. Chir Orthop 1937;30:227.
  • 5 Jewett TC Jr., Duszynski DO, Allen JE. The visualization of Meckel's diverticulum with 99mTc-pertechnetate. Surgery 1970;68:567-70.
  • 6 Spottswood SE, Pfluger T, Bartold SP, Brandon D, Burchell N, Delbeke D, et al. SNMMI and EANM practice guideline for Meckel diverticulum scintigraphy 2.0. J Nucl Med Technol 2014;42:163-9.
  • 7 Menezes M, Tareen F, Saeed A, Khan N, Puri P. Symptomatic meckel's diverticulum in children: A 16-year review. Pediatr Surg Int 2008;24:575-7.
  • 8 Chen JJ, Lee HC, Yeung CY, Chan WT, Jiang CB, Sheu JC, et al. Meckel's diverticulum: Factors associated with clinical manifestations. ISRN Gastroenterol 2014;2014:390869.
  • 9 Mittal BR, Kashyap R, Bhattacharya A, Singh B, Radotra BD, Narasimha Rao KL, et al. Meckel's diverticulum in infants and children; technetium-99m pertechnetate scintigraphy and clinical findings. Hell J Nucl Med 2008;11:26-9.
  • 10 Blevrakis E, Partalis N, Seremeti C, Sakellaris G. Meckel's diverticulum in paediatric practice on Crete (Greece): A 10-year review. Afr J Paediatr Surg 2011;8:279-82.
  • 11 Jay GD 3rd, Margulis RR, McGraw AB, Northrip RR. Meckel's diverticulum; a survey of one hundred and three cases. Arch Surg 1950;61:158-69.
  • 12 Oldham KT, Wesley JR. The pediatric abdomen. In: Greenfield LJ, editor. Surgery: Scientific Principles and Practice. Philadelphia: JB Lippincott; 1993. p. 1832-82.
  • 13 Wu H, Zhao X, Li Y, Zhao R. Reconsideration of the primary and secondary diagnostic criteria of Meckel's diverticulum scintigraphy. A study of 93 confirmed cases. Hell J Nucl Med 2017;20:11-6.
  • 14 Al Janabi M, Samuel M, Kahlenberg A, Kumar S, Al-Janabi M. Symptomatic paediatric Meckel's diverticulum: Stratified diagnostic indicators and accuracy of Meckel's scan. Nucl Med Commun 2014;35:1162-6.
  • 15 Vourlioti P. Scintiscan with sodium hypertechnetate in the diagnosis of Meckel's diverticulum. Hell J Nucl Med 2001;2:66-70.
  • 16 Mukai M, Takamatsu H, Noguchi H, Fukushige T, Tahara H, Kaji T, et al. Does the external appearance of a Meckel's diverticulum assist in choice of the laparoscopic procedure? Pediatr Surg Int 2002;18:231-3.