Anitha Dharmalingam, Shwetal Pawar U, Suruchi Shetye S, Mangala Ghorpade K
Department of Nuclear Medicine Surgery, Seth G.S Medical College and KEM Hospital, Parel, Mumbai, India.
World J Nucl Med. 2020 Jan 14;19(1):52-55. doi: 10.4103/wjnm.WJNM_27_19. eCollection 2020 Jan-Mar.
Complicated Meckel's diverticulum (MD) in pediatric age group may not present with classic symptoms or signs. The routine modalities of investigations for the detection of MD are ultrasonography (US), computerized tomography, and air enema. However, these may miss the diagnosis in cases of atypical patterns of presentation. In such situations, the radionuclide Meckel scan helps to narrow down the diagnosis. The objective of this case report was to present an unusual presentation of MD where the diagnosis was established by a radionuclide scan against other methods which were equivocal. An 8-year-old boy was admitted with features of intestinal obstruction. Tc-pertechnetate Meckel's scintigraphy showed localization of tracer in ectopic gastric mucosa. The surgical exploration after the Meckel's scan revealed a curve-shaped MD localized 50 cm proximal to the ileocecal valve. The surgery was completed after a diverticulectomy, and the patient was relived of symptoms. MD scintigraphy can help detect ectopic gastric mucosa in cases of unusual presentation by considering the atypical presentation, variation in shape, and location on Meckel's scan and improve the disease management.
小儿复杂型梅克尔憩室（MD）可能不会表现出典型症状或体征。检测MD的常规检查方式包括超声检查（US）、计算机断层扫描和空气灌肠。然而，对于非典型表现的病例，这些检查可能会漏诊。在这种情况下，放射性核素梅克尔扫描有助于明确诊断。本病例报告的目的是呈现MD的一种不寻常表现，通过放射性核素扫描确诊，而其他方法的诊断结果不明确。一名8岁男孩因肠梗阻症状入院。锝-高锝酸盐梅克尔闪烁扫描显示示踪剂在异位胃黏膜中定位。梅克尔扫描后进行的手术探查发现一个弯曲形的MD，位于回盲瓣近端50厘米处。憩室切除术后手术完成，患者症状缓解。MD闪烁扫描通过考虑梅克尔扫描中不典型的表现、形状变化和位置，有助于在不寻常表现的病例中检测异位胃黏膜，并改善疾病管理。
