Detection of ectopic gastric mucosa in Meckel's diverticulum and in other aberrations by scintigraphy: I. Pathophysiology and 10-year clinical experience.

Ten years of clinical experience with pertechnetate (Tc-99m) scintigraphy has proven its validity for the diagnosis of ectopic gastric mucosa in bleeding Meckel's diverticulum and other congenital anomalies. Careful patient preparation and a standardized technique based on sequential gamma imaging has resulted in an overall sensitivity of 85%. Experience in differentiating "nonspecific" accumulations of pertechnetate from true ectopic gastric mucosa had increased the specificity to 95%. When we consider all the studies reported (954) with a surgical or clinical diagnosis, the accuracy of the method is calculated at 98%. When only surgically proven cases are analyzed, the calculated accuracy is 90%. Pertechnetate excretion by the mucoid cells of gastric mucosa is the basis of this test. The effect of drugs and hormones on the test has been studied in animals and in patients. The findings suggest that an improvement can be achieved by the use of cimetidine, pentagastrin, or glucagon.