7 Although use of 99m Tc scan has demonstrated diagnostic accuracy, the false-negative rate can be high, especially in adults. Copyright © 1974 Published by Elsevier Inc. https://doi.org/10.1016/S0022-3468(74)80226-5. A technetium-99 scan was performed in an 18-year-old man with abdominal pain, vomiting and rectal bleeding to confirm the presence of a Meckel's diverticulum which was not diagnosed laparoscopically elsewhere. You must have JavaScript enabled to enjoy a limited number of articles over the next 360 days. Clin Nucl Med. Das Meckel-Divertikel (auch Meckelsches Divertikel, lateinisch Diverticulum ilei) – benannt nach dem deutschen Anatom Johann Friedrich Meckel (1781–1833) – ist eine Ausstülpung des Leerdarms bzw.Krummdarms (), das einen Rest des embryonalen Dottergangs (Ductus omphaloentericus, die Verbindung zum Dottersack) darstellt.Beim menschlichen Neugeborenen ist dieses Divertikel ca. Meckel's diverticulum. 1985 Oct;80(10):781-3. J Pediatr Surg 1999;34:760-765. It is unclear if SPECT is able to detect even smaller volumes.  |  National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. „Meckel Scan") nachzuweisen. Diese hat jedoch nur eine geringe Treffsicherheit und hilft uns bei der Entscheidung, ob wir eine Bauchspiegelung durchführen müssen, nicht weiter. In one series, only 6% of patients were diagnosed preoperatively.1. Smith FR, Rheingold OJ, Kanner R, Rogers AI. Connolly J, et al. J Nucl Med 1998;39:1458-1459. a. have a low positive predictive value in the diagnosis of a bleeding Meckel’s diverticulum. 1996 Mar;166(3):567-73. doi: 10.2214/ajr.166.3.8623629. ABSTRACT & COMMENTARY Synopsis: Technetium-99 "Meckel’s scans" have a relatively low predictive value and may result in the need for operative evaluation despite negative scan results. … Clinical impressions had a major effect on the decision-making process in these patients, despite the results of the scan. (Dr. Schwartz is Associate Professor of Diagnostic Radiology [Pediatrics] at the Yale University School of Medicine.). Eight patients with a false negative scan were found to have Meckel’s diverticuli containing ectopic gastric mucosa at surgery. Synopsis: Technetium-99 "Meckel’s scans" have a relatively low predictive value and may result in the need for operative evaluation despite negative scan results. Get the latest public health information from CDC: https://www.coronavirus.gov. In the study of 119 patients, technetium Tc 99m (99m Tc) scan, also known as Meckel's scan, was positive in 3 of 4 patients. When planar scintigraphic imaging is used, it is generally accepted that gastric mucosa of 1 cm2 is required for proper identification. Therefore, they advocate the addition of "minimally invasive laparoscopy," or exploratory laparotomy, instead of nuclear medicine imaging, to the diagnostic algorithm of identifying the presence of a bleeding Meckel’s diverticulum in the evaluation of pediatric patients with clinically significant GI bleeding and a high index of suspicion for a bleeding Meckel’s diverticulum. For most children, no anesthesia or sedation is required for nuclear medicine imaging as long as the child can be safely restrained for the duration of the study. A subclass of patients—those with lower GI bleeding and a hemoglobin level of less than 11.0 g/dL who underwent a Meckel’s scan—were assessed for use of the scan. Am J Gastroenterol. USA.gov. However, the addition of single photon emission computed tomography (SPECT) imaging may further increase the detection of a small Meckel’s diverticulum by precisely depicting the radionuclide distribution within a small volume of tissue.2 SPECT is analogous to CT and MR in that multiplanar imaging is obtained and displayed as thin sections. Yamaguchi M, et al. By continuing you agree to the use of cookies. The technetium-99 scan was positive and a diagnostic laparoscopy was re-performed which revealed a Meckel's diverticulum that was subsequently resected. Improving technology may improve these numbers in the future. Both clinical and radiologic examinations are often nondiagnostic. The aim of the present study was to assess the use of technetium (Tc) 99m pertechnetate scintigraphy (Meckel’s scan) in the diagnostic workup of the pediatric patient with GI bleeding and a suspected Meckel’s diverticulum. Please enable it to take advantage of the complete set of features! NLM Am J Surg 1978;136:247-248. A technetium-99m pertechnetate scan, also called Meckel scan, is the investigation of choice to diagnose Meckel's diverticula in children. The use of Tc 99m-pertechnetate continues to be a sensitive and specific test (85-90% and 95%, respectively) with a reported accuracy of 90-98%. Swaniker et al do not describe the sizes of the lesions resected in the present cases; perhaps only the smaller lesions were missed. A case of a Meckel's diverticulum is described in a young man presenting with abdominal pain and gastrointestinal bleeding. 1-800-370-9210 Methods of arriving at the diagnosis preoperatively are reviewed. This site needs JavaScript to work properly. However, in symptomatic patients who present with lower GI bleeding or bowel obstruction, the diagnosis is often made after much difficulty. In all patients, the Meckel’s scan had a positive and negative predictive value of 0.93.

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