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Meckel diverticulum scintigraphy: technique, findings and diagnostic pitfalls

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Abstract

Meckel diverticulum, the most common congenital anomaly of the gastrointestinal tract, results from the aberrant involution of the omphalomesenteric duct and accounts for more than 50% of unexplained lower gastrointestinal bleeding in the pediatric population. The most accurate imaging tool to identify a Meckel diverticulum containing ectopic gastric mucosa is the Technetium-99m pertechnetate Meckel scan, a scintigraphic study with a reported accuracy of 90% in the pediatric population. In addition to depicting a Meckel diverticulum with ectopic gastric mucosa, careful attention to the normal biodistribution of the radiotracer can lead to the identification of unexpected pathology with implications for patient management. This article serves to review the embryological origin and anatomical features of Meckel diverticulum, highlight the role of scintigraphy in evaluating Meckel diverticulum, and discuss the proper imaging technique when performing this test. We will focus on pitfalls that can lead to an erroneous diagnosis as well as incidental findings that can affect patient management.

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Authors and Affiliations

  1. Department of Radiology, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA, 98195, USA

    Hassan A. Aboughalia, Safia H. E. Cheeney & Marguerite T. Parisi

  2. Department of Radiology, Seattle Children’s Hospital, Seattle, WA, USA

    Safia H. E. Cheeney & Marguerite T. Parisi

  3. Department of Radiology, Medical University of South Carolina, Charleston, SC, USA

    Saeed Elojeimy

  4. Department of Radiology, University of New Mexico, Albuquerque, NM, USA

    Lisa C. Blacklock

  5. Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA

    Marguerite T. Parisi

  6. Department of Pediatrics, Seattle Children’s Hospital, Seattle, WA, USA

    Marguerite T. Parisi

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  1. Hassan A. Aboughalia
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  2. Safia H. E. Cheeney
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Correspondence to Hassan A. Aboughalia.

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Aboughalia, H.A., Cheeney, S.H.E., Elojeimy, S. et al. Meckel diverticulum scintigraphy: technique, findings and diagnostic pitfalls. Pediatr Radiol 53, 493–508 (2023). https://doi.org/10.1007/s00247-022-05527-z

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  • DOI: https://doi.org/10.1007/s00247-022-05527-z

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