Meckel's Diverticulum in Infants and Children; Technetium-99m Pertechnetate Scintigraphy and Clinical Findings

Meckel's diverticulum (MD) is the most common congenital gastrointestinal anomaly. About 50% of diverticulae contain ectopic gastric mucosa. Gastric mucosal secretions can cause peptic ulceration resulting in pain, bleeding and perforation. Technetium-99m ((99m)Tc) pertechnetate scintigraphy is helpful in diagnosing ectopic gastric mucosa. We have conducted a retrospective analysis of scintigraphic data of 107 pediatric patients, 28 females and 79 males, their age ranging from 5 days to 11 years who referred to us for a query diagnosis of MD. Our results have shown that the most frequent presenting symptom was bleeding per rectum. Twenty-one cases of the 107 were positive for functioning gastric tissue indicating MD (19.62%). Maximum clustering of positive cases was at the age group of 1-2 years (11 cases i.e. 52.38%). The site of the ectopic activity was mainly at the umbilical quatrum in 11 cases (52.4%). Two patients were lost to follow-up and hence surgery could not be performed. The remaining 19 cases were subjected to surgical intervention and 16 were found to be positive for MD. The scintiscan was true positive in 84.2%. Our findings were in agreement with those of other authors. In conclusion, in pediatric patients (99m)Tc-pertechnetate scintigraphy is by 84.2% true positive for gastric mucosa, indicating MD.