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- W4311303513 abstract "Jaros R, Schussheim A, Levy LM. Preoperative diagnosis of bleeding Meckel's diverticulum utilizing 99m technetium pertechnetate scinti-imaging. J Pediatr 1973;82:45-9. Meckel diverticulum results from incomplete obliteration of the vestigial vitelline duct and is the most common congenital abnormality of the gastrointestinal tract, affecting approximately 2% of the population.1Hansen C.C. Søreide K. Systematic review of epidemiology, presentation, and management of Meckel's diverticulum in the 21st century.Medicine (Baltimore). 2018; 97: e12154Crossref PubMed Scopus (103) Google Scholar Meckel diverticulum is located in the ileum and usually contains ectopic gastric mucosa, which can cause ulceration of the adjacent ileal mucosa and rectal bleeding but also can contain pancreatic, duodenal, or colonic mucosa. Fifty years ago, children with rectal bleeding of unknown etiology would undergo an exploratory laparotomy in search of a Meckel diverticulum or other cause. In 1973, 99technetium pertechnetate scintigraphy, now known as the Meckel scan, was first used in pediatric patients perioperatively to diagnose Meckel diverticulum with ectopic gastric mucosa. Jaros et al used the technology in 5 children with rectal bleeding of unknown etiology. Two of these children had positive scans and subsequently had surgery to excise a Meckel diverticulum; 3 children had normal scans and avoided unnecessary laparotomies. Although most patients remain asymptomatic, a recent study of 945 children with Meckel diverticulum found that 60% presented with bowel obstruction including intussusception, 36% presented with bleeding, and 8% presented with inflammation, which can appear as appendicitis-like symptoms in a patient with a normal appendix.2Alemayehu H. Hall M. Desai A.A. St Peter S.D. Snyder C.L. Demographic disparities of children presenting with symptomatic Meckel’s diverticulum in children’s hospitals.Pediatr Surg Int. 2014; 30: 649-653Crossref PubMed Scopus (21) Google Scholar Many imaging modalities, including angiography, video capsule endoscopy, and small-bowel enteroscopy, can detect a Meckel diverticulum but are not commonly used for this purpose. Although there have been technical advances to the scan since 1973, when Polaroid films augmented a 90-minute digital recording, it maintains the same underlying technology. Now, premedication with H2 antagonists often is used to enhance tracer uptake into gastric tissue, and a Meckel scan has high sensitivity and specificity, both approaching 100%.3Irvine I. Doherty A. Hayes R. Bleeding meckel’s diverticulum: A study of the accuracy of pertechnetate scintigraphy as a diagnostic tool.Eur J Radiol. 2017; 96: 27-30Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar Today, the Meckel scan remains the study of choice in hemodynamically stable patients with rectal bleeding and should be used for prompt recognition and differentiation of this congenital anomaly from other conditions with similar clinical presentations." @default.
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- W4311303513 date "2023-01-01" @default.
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- W4311303513 title "50 Years Ago in T J P" @default.
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- W4311303513 doi "https://doi.org/10.1016/j.jpeds.2022.11.005" @default.
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