sodium-pertechnetate-tc-99m and Abdominal-Pain

A 28-year-old Chinese man presented with acute bleeding per rectum. Computed tomography showed a posterior outpouching arising from the distal ileum. The outpouching had hyperaemic walls, but no active contrast extravasation was detected. Technetium-99m pertechnetate scintigraphy showed focal areas of abnormal uptake in the right side of the pelvis, superior and posterior to the urinary bladder. These areas of uptake appeared simultaneously with the gastric uptake and demonstrated gradual increase in intensity on subsequent images. The diagnosis of Meckel's diverticulum was confirmed on surgery and the lesion was resected. The clinical and imaging features of Meckel's diverticulum are discussed.

Topics: Abdominal Pain; Adult; Female; Gastrointestinal Hemorrhage; Humans; Ileum; Male; Meckel Diverticulum; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Tomography, X-Ray Computed

Intestinal duplication is an uncommon congenital condition in young adults. A 25-year-old man complained of chronic, intermittent abdominal pain for 3 years following previous appendectomy for the treatment of suspected appendicitis. Abdominal discomfort and pain, suggestive of intestinal obstruction, recurred after operation. A tubular mass was palpable in the right lower quadrant. Computed tomography enterography scan identified suspicious intestinal intussusception, while Tc-99m pertechnetate scintigraphy revealed a cluster of strip-like abnormal radioactivity in the right lower quadrant. On exploratory laparotomy, a tubular-shaped ileal duplication cyst was found arising from the mesenteric margin of the native ileal segment located 15 cm proximal to the ileocecal valve. Ileectomy was performed along with the removal of the duplication disease, and the end-to-end anastomosis was done to restore the gastrointestinal tract continuity. Pathological examination showed ileal duplication with ectopic gastric mucosa. The patient experienced an eventless postoperative recovery and remained asymptomatic within 2 years of postoperative follow-up.

Topics: Abdominal Pain; Adult; Anastomosis, Surgical; Choristoma; Cysts; Diagnosis, Differential; Gastric Mucosa; Humans; Ileal Diseases; Ileum; Intussusception; Male; Predictive Value of Tests; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Tomography, X-Ray Computed; Treatment Outcome

Topics: Abdominal Pain; Anorexia; Appendicitis; Child; Diagnosis, Differential; Diarrhea; Diverticulitis; Fever; Humans; Male; Meckel Diverticulum; Peritonitis; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Tomography, Spiral Computed; Vomiting

Topics: Abdominal Pain; Child; Diverticulitis; Fever of Unknown Origin; Gastric Mucosa; Humans; Kidney Failure, Chronic; Male; Meckel Diverticulum; Positron-Emission Tomography; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Tomography, X-Ray Computed

A new cause of a false-positive result of a Meckel's scan is reported. An 11-year-old girl had a 3-week history of constant right lower quadrant pain that was initially managed by laparoscopic appendectomy. A repeated laparoscopy for persistent pain was nondiagnostic. A missed Meckel's diverticulum was considered as the cause of this pain, which prompted a Meckel scan. This scan revealed a periumbilical focus of activity that was interpreted as a Meckel's diverticulum attached to the anterior abdominal wall by a band. The laparotomy showed no Meckel's diverticulum. The false-positive result of the Meckel scan may be the result of inflammation from the periumbilical laparoscopic port site.

Topics: Abdominal Pain; Appendectomy; Appendicitis; Child; False Positive Reactions; Female; Humans; Laparoscopy; Meckel Diverticulum; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m

The results from an ultrasound study performed on an 11-year-old boy, who had several weeks of intermittent abdominal pain, showed a nonperistaltic loop of bowel near the umbilicus, which suggested either an internal hernia or a diverticulum. Tc-99m pertechnetate imaging showed a focal collection near the umbilicus, which was consistent with a Meckel's diverticulum. No evidence was found of gastrointestinal bleeding. Exploratory laparotomy showed a Meckel's diverticulum near the terminal ileum and attached to the anterior abdominal wall close to the umbilicus. Small bowel had herniated through the loop formed by the terminal ileum and the diverticulum.

Topics: Abdominal Pain; Child; Gastrointestinal Hemorrhage; Hernia; Humans; Ileal Diseases; Laparotomy; Male; Meckel Diverticulum; Peristalsis; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Tissue Adhesions; Ultrasonography; Umbilicus