The value of repeat scintigraphy in patients with a high clinical suspicion for Meckel diverticulum after a negative or equivocal first Meckel scan

Abstract

Repeat Meckel scans in patients with equivocal findings on the first study or a negative result with a high clinical suspicion for a Meckel diverticulum are useful especially in cases in which the first study had been done without appropriate preparation.

Systematic review of epidemiology, presentation, and management of Meckel's diverticulum in the 21st century

“…[45] Repeat scans when results are inconclusive or clinical suspicion is high is also a viable option. [58] Restricting use of the test to certain indications, such as anemic patients with GI-hemorrhage, is also important to ensure high sensitivity and specificity. [57]…”

Bleeding Meckel’s Diverticulum in Children: The Diagnostic Value of Double-Balloon Enteroscopy

“…Ectopic gastric mucosa was found in all 6 patients. The false negativity of Meckel's scan may be attributed to an insufficient ectopic gastric mucosa, diluted radioactivity due to hemorrhage or intestinal hypersecretion, or inadequate patient preparation such as premedication with pentagastrin, glucagon, and H 2 blocker to increase sensitivity of Meckel's scan [ 5 ].…”

“…Technetium-99m pertechnetate scan (Meckel's scan) is currently the standard noninvasive method for preoperative diagnosis of MD in children with lower GI hemorrhage, with a sensitivity of 85% and specificity of 95% [ 4 ]. A repeat Meckel's scan is recommended if the initial scan is negative or equivocal, but clinical suspicion for MD is still high or patient preparation is inappropriate [ 5 ].…”

Clinical manifestations of Meckel Diverticulum in children: a review of 11-years

“…11 False-negative diagnosis may be due to ulcers and hemorrhage without ectopic gastric mucosa to capture Tc-99m or if the area of ectopic gastric mucosa is very small and can be missed on the Meckel's scan; 7 alternatively, if there is profuse bleeding or an accentuated intestinal transit, the radioisotope can be washed out. 3,7 Several techniques have been introduced to increase the sensitivity. Premedication with histamine H2 blockers, glucagon, and pentagastrin, bladder lavage, nasogastric suctioning and recently Single-photon emission computed tomography (SPECT) and SPECT/CT have been reported to increase sensitivity.…”

“…Meckel's diverticulum (MD) is the most common congenital gastrointestinal malformation in children. [1][2][3] This develops as a result of incomplete obliteration of vitelline duct around the 5 th to 7 th weeks of gestation. Its incidence is estimated to be between 0,3% and 2,9% of the general population, however in most patients it's clinically silent and often an incidentally finding during surgery.…”