The significance of Meckel's scan in pediatric gastrointestinal bleeding cases: A case report

Meckel's diverticulum is the most prevalent congenital anomaly of the gastrointestinal tract, identified in 2% of the population according to autopsy studies. Most patients remain asymptomatic throughout their lives and are typically diagnosed when complications arise. The diagnosis can be chal...

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Main Authors: Damayanti Sekarsari, MD, Ella Putri Saptari, MD, Mohamad Yanuar Amal, MD, Quinta Febryani Handoyono, MD, Alvita Dewi Siswoyo, MD, Sastiono, MD, Hanifah Oswari, MD, Ening Krisnuhoni, MD
Format: Article
Language:English
Published: Elsevier 2024-07-01
Series:Radiology Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1930043324002565
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author Damayanti Sekarsari, MD
Ella Putri Saptari, MD
Mohamad Yanuar Amal, MD
Quinta Febryani Handoyono, MD
Alvita Dewi Siswoyo, MD
Sastiono, MD
Hanifah Oswari, MD
Ening Krisnuhoni, MD
author_facet Damayanti Sekarsari, MD
Ella Putri Saptari, MD
Mohamad Yanuar Amal, MD
Quinta Febryani Handoyono, MD
Alvita Dewi Siswoyo, MD
Sastiono, MD
Hanifah Oswari, MD
Ening Krisnuhoni, MD
author_sort Damayanti Sekarsari, MD
collection DOAJ
description Meckel's diverticulum is the most prevalent congenital anomaly of the gastrointestinal tract, identified in 2% of the population according to autopsy studies. Most patients remain asymptomatic throughout their lives and are typically diagnosed when complications arise. The diagnosis can be challenging, but imaging is crucial for promptly identifying and distinguishing it from other conditions that have similar clinical manifestations. A 13-year-old male was admitted with a 5-day history of rectal bleeding. The patient continued to experience painless gastrointestinal bleeding, indicating the performance of a Tc-99m pertechnetate scintigraphy or Meckel's scan. Planar images revealed focal uptake within the right hemiabdomen, suggestive of the presence of a Meckel's diverticulum. Subsequent laparotomy surgery confirmed the presence of a Meckel's diverticulum located 50 cm from the ileocecal valve. Histopathological examination of the resected specimen confirmed Meckel's diverticulum with ectopic gastric mucosa. This patient with Meckel's diverticulum exhibited minimal abdominal symptoms, and there were no other complications such as intussusception, which could lead to bowel obstruction. Technetium-99m pertechnetate scintigraphy is a common method for evaluating children with unexplained gastrointestinal tract bleeding. SPECT/CT fusion imaging enables the simultaneous fusion of functional and anatomical information, preventing false-negative scintigraphy examinations. Its capability to precisely localize activity in abnormal structures contributes to accurate scan interpretation. Complications of Meckel's diverticulum are uncommon and pose a diagnostic challenge. Through comprehensive history-taking, physical examination, and nuclear imaging, the diagnosis can be identified, and surgical intervention can be performed to achieve the best possible outcome for the patient.
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spelling doaj.art-38636f390ab24a249362a3aaf6deb70e2024-04-21T04:14:22ZengElsevierRadiology Case Reports1930-04332024-07-0119727672772The significance of Meckel's scan in pediatric gastrointestinal bleeding cases: A case reportDamayanti Sekarsari, MD0Ella Putri Saptari, MD1Mohamad Yanuar Amal, MD2Quinta Febryani Handoyono, MD3Alvita Dewi Siswoyo, MD4 Sastiono, MD5Hanifah Oswari, MD6Ening Krisnuhoni, MD7Division of Pediatric Radiology, Department of Radiology, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital, Salemba Raya No. 4, Kenari, Senen, Central Jakarta, DKI Jakarta, Indonesia; Corresponding author.Department of Radiology, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital, Salemba Raya No. 4, Kenari, Senen, Central Jakarta, DKI Jakarta, IndonesiaDivision of Pediatric Radiology, Department of Radiology, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital, Salemba Raya No. 4, Kenari, Senen, Central Jakarta, DKI Jakarta, IndonesiaDepartment of Radiology, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital, Salemba Raya No. 4, Kenari, Senen, Central Jakarta, DKI Jakarta, IndonesiaDepartment of Nuclear Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital, Salemba Raya No. 4, Kenari, Senen, Central Jakarta, DKI Jakarta, IndonesiaDivision of Pediatric Surgery, Department of Surgery, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital, Salemba Raya No. 4, Kenari, Senen, Central Jakarta, DKI Jakarta, IndonesiaDivision of Gastrohepatology, Department of Pediatrics, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital, Salemba Raya No. 4, Kenari, Senen, Central Jakarta, DKI Jakarta, IndonesiaDepartment of Anatomic Pathology, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital, Salemba Raya No. 4, Kenari, Senen, Central Jakarta, DKI Jakarta, IndonesiaMeckel's diverticulum is the most prevalent congenital anomaly of the gastrointestinal tract, identified in 2% of the population according to autopsy studies. Most patients remain asymptomatic throughout their lives and are typically diagnosed when complications arise. The diagnosis can be challenging, but imaging is crucial for promptly identifying and distinguishing it from other conditions that have similar clinical manifestations. A 13-year-old male was admitted with a 5-day history of rectal bleeding. The patient continued to experience painless gastrointestinal bleeding, indicating the performance of a Tc-99m pertechnetate scintigraphy or Meckel's scan. Planar images revealed focal uptake within the right hemiabdomen, suggestive of the presence of a Meckel's diverticulum. Subsequent laparotomy surgery confirmed the presence of a Meckel's diverticulum located 50 cm from the ileocecal valve. Histopathological examination of the resected specimen confirmed Meckel's diverticulum with ectopic gastric mucosa. This patient with Meckel's diverticulum exhibited minimal abdominal symptoms, and there were no other complications such as intussusception, which could lead to bowel obstruction. Technetium-99m pertechnetate scintigraphy is a common method for evaluating children with unexplained gastrointestinal tract bleeding. SPECT/CT fusion imaging enables the simultaneous fusion of functional and anatomical information, preventing false-negative scintigraphy examinations. Its capability to precisely localize activity in abnormal structures contributes to accurate scan interpretation. Complications of Meckel's diverticulum are uncommon and pose a diagnostic challenge. Through comprehensive history-taking, physical examination, and nuclear imaging, the diagnosis can be identified, and surgical intervention can be performed to achieve the best possible outcome for the patient.http://www.sciencedirect.com/science/article/pii/S1930043324002565Pediatric gastrointestinal bleedingMeckel's diverticulumTc-99m pertechnetate scintigraphySPECT/CT
spellingShingle Damayanti Sekarsari, MD
Ella Putri Saptari, MD
Mohamad Yanuar Amal, MD
Quinta Febryani Handoyono, MD
Alvita Dewi Siswoyo, MD
Sastiono, MD
Hanifah Oswari, MD
Ening Krisnuhoni, MD
The significance of Meckel's scan in pediatric gastrointestinal bleeding cases: A case report
Radiology Case Reports
Pediatric gastrointestinal bleeding
Meckel's diverticulum
Tc-99m pertechnetate scintigraphy
SPECT/CT
title The significance of Meckel's scan in pediatric gastrointestinal bleeding cases: A case report
title_full The significance of Meckel's scan in pediatric gastrointestinal bleeding cases: A case report
title_fullStr The significance of Meckel's scan in pediatric gastrointestinal bleeding cases: A case report
title_full_unstemmed The significance of Meckel's scan in pediatric gastrointestinal bleeding cases: A case report
title_short The significance of Meckel's scan in pediatric gastrointestinal bleeding cases: A case report
title_sort significance of meckel s scan in pediatric gastrointestinal bleeding cases a case report
topic Pediatric gastrointestinal bleeding
Meckel's diverticulum
Tc-99m pertechnetate scintigraphy
SPECT/CT
url http://www.sciencedirect.com/science/article/pii/S1930043324002565
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