Ayala S, Andrés A, Rambalde E F, Deus J, Cáncer L, Tardin L, Banzo J, Prats E
Servicio de Medicina Nuclear, Hospital Clínico Universitario "Lozano Blesa", Avda. San Juan Bosco, 15, 50009 Zaragoza, Spain.
Servicio de Medicina Nuclear, Hospital Clínico Universitario "Lozano Blesa", Avda. San Juan Bosco, 15, 50009 Zaragoza, Spain.
Rev Esp Med Nucl Imagen Mol. 2014 Jul-Aug;33(4):231-3. doi: 10.1016/j.remn.2013.12.003. Epub 2014 Feb 21.
We analyze the case of a patient with intermittent episodes of lower gastrointestinal bleeding and suspected Meckel's diverticulum, whose presence was confirmed by (99m)Tc-pertechnetate scintigraphy. A previous exploratory laparotomy had been performed without finding the diverticulum. In spite of years of medical treatment, the patient presented a new episode of lower gastrointestinal bleeding with normal colonoscopy. A new (99m)Tc-pertechnetate scintigraphy (including SPECT/CT) was performed and allowed the anatomical location of a Meckel's diverticulum and enabled its removal by laparoscopic radioguided surgery. The introduction of SPECT/CT in the scintigraphic diagnostic protocol in Meckel's diverticulum increases diagnostic safety and improves lesion location. Furthermore, it favors the performance of radioguided surgery and facilitates the lesion resection, particularly when the patient has suffered previous abdominal surgery, with a more conservative procedure, reducing the morbidity associated with the surgical procedure.
我们分析了一例患有下消化道间歇性出血且疑似梅克尔憩室的患者病例，其梅克尔憩室的存在通过（99m）锝高锝酸盐闪烁扫描得以证实。此前进行过一次剖腹探查术，但未发现憩室。尽管经过多年治疗，该患者在结肠镜检查正常的情况下仍出现了新的下消化道出血发作。于是进行了一次新的（99m）锝高锝酸盐闪烁扫描（包括单光子发射计算机断层扫描/计算机断层扫描），确定了梅克尔憩室的解剖位置，并通过腹腔镜放射性引导手术将其切除。在梅克尔憩室闪烁扫描诊断方案中引入单光子发射计算机断层扫描/计算机断层扫描提高了诊断安全性并改善了病变定位。此外，它有利于进行放射性引导手术并便于病变切除，特别是当患者既往有腹部手术史时，采用更保守的手术方式，可降低与手术相关的发病率。
