eMedicine Specialties > Radiology > Pediatrics

Meckel Diverticulum: Follow-up

Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, LRCP, Chairman of Medical Imaging, Professor of Radiology, NGHA, King Fahad National Guard Hospital, King Abdulaziz Medical City, Riyadh, Saudi Arabia
Coauthor(s): Muthusamy Chandramohan, MBBS, DMRD, FRCR, Consultant Radiologist, Bradford Teaching Hospitals, UK; Sumaira MacDonald, MBChB, PhD, MRCP, FRCR, Lecturer, Sheffield University Medical School; Endovascular Fellow, Sheffield Vascular Institute
Contributor Information and Disclosures

Updated: May 6, 2008

Intervention

When diagnostic angiography images depict severe gastrointestinal tract bleeding, superselective embolization should be considered so that surgery can be performed under stable conditions.3,11,16

Medicolegal Pitfalls

  • Despite the reported sensitivity of radionuclide scanning, controversy remains regarding its use.
    • Some clinicians believe that radionuclides have a limited role in the diagnosis of Meckel diverticulum and that imaging of all types should be replaced by laparoscopy, which offers the additional possibility of laparoscopic resection of a Meckel diverticulum.
    • However, when used appropriately with meticulous technique in the appropriate age group, scintigraphy remains the best technique available for the diagnosis of a Meckel diverticulum.14
    • The radiation dose to the patient is small and acceptable.
  • Laparoscopy is more invasive and poses a risk of morbidity.

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More on Meckel Diverticulum

Overview: Meckel Diverticulum
Imaging: Meckel Diverticulum
Follow-up: Meckel Diverticulum
Multimedia: Meckel Diverticulum
References
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References

  1. Pantongrag-Brown L, Levine MS, Buetow PC, et al. Meckel''s enteroliths: clinical, radiologic, and pathologic findings. AJR Am J Roentgenol. Dec 1996;167(6):1447-50. [Medline].

  2. Ariga M, Suga K, Matsunaga N, et al. Failure to detect a huge Meckel''s diverticulum with abundant ectopic gastric mucosa on gastric mucosal scintigraphy with Tc-99m pertechnetate. Clin Nucl Med. May 2001;26(5):470-1. [Medline].

  3. Ford PV, Bartold SP, Fink-Bennett DM, et al. Procedure guideline for gastrointestinal bleeding and Meckel''s diverticulum scintigraphy. Society of Nuclear Medicine. J Nucl Med. Jul 1999;40(7):1226-32. [Medline].

  4. Groebli Y, Bertin D, Morel P. Meckel''s diverticulum in adults: retrospective analysis of 119 cases and historical review. Eur J Surg. Jul 2001;167(7):518-24. [Medline].

  5. Hol L, Kuipers EJ. Clinical challenges and images in GI. Meckel's diverticulum. Gastroenterology. Aug 2007;133(2):392, 732. [Medline].

  6. You JS, Chung SP, Park YS, Yu JS, Park YA. A case of strangulated small bowel obstruction caused by Meckel's diverticulum in an adult. J Emerg Med. Aug 2007;33(2):133-5. [Medline].

  7. van Es HW, Sybrandy R. Diagnosis please. Case 19: enteroliths in a Meckel diverticulum. Radiology. Feb 2000;214(2):524-6. [Medline].

  8. Emamian SA, Shalaby-Rana E, Majd M. The spectrum of heterotopic gastric mucosa in children detected by Tc- 99m pertechnetate scintigraphy. Clin Nucl Med. Jun 2001;26(6):529-35. [Medline].

  9. Linebarger JS, Roy ML. Focus on diagnosis: common nuclear medicine studies in pediatrics. Pediatr Rev. Nov 2007;28(11):415-7. [Medline].

  10. Delle Chiaie L, Neuberger P. Early prenatal sonographic detection of an uncomplicated Meckel diverticulum. Ultrasound Obstet Gynecol. Oct 2007;30(5):790-1. [Medline].

  11. Mitchell AW, Spencer J, Allison DJ, Jackson JE. Meckel''s diverticulum: angiographic findings in 16 patients. AJR Am J Roentgenol. May 1998;170(5):1329-33. [Medline].

  12. Navarro O, Dugougeat F, Kornecki A, et al. The impact of imaging in the management of intussusception owing to pathologic lead points in children. A review of 43 cases. Pediatr Radiol. Sep 2000;30(9):594-603. [Medline].

  13. Nolan DJ. The true yield of the small-intestinal barium study. Endoscopy. Aug 1997;29(6):447-53. [Medline].

  14. Omar AM, Al-Saee''d TA, Elgazzar A. Scintigraphic pattern of intestinal duplication on a Meckel''s diverticulum scan. Clin Nucl Med. Oct 1998;23(10):708-9. [Medline].

  15. Swaniker F, Soldes O, Hirschl RB. The utility of technetium 99m pertechnetate scintigraphy in the evaluation of patients with Meckel''s diverticulum. J Pediatr Surg. May 1999;34(5):760-4; discussion 765. [Medline].

  16. Okazaki M, Higashihara H, Yamasaki S, et al. Arterial embolization to control life-threatening hemorrhage from a Meckel''s diverticulum. AJR Am J Roentgenol. Jun 1990;154(6):1257-8. [Medline].

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Further Reading

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Keywords

Meckel's diverticulum, Meckel diverticula, diverticulum of the ileum, intestinal obstruction, intestinal hemorrhage, hernia of Littre

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Contributor Information and Disclosures

Author

Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, LRCP, Chairman of Medical Imaging, Professor of Radiology, NGHA, King Fahad National Guard Hospital, King Abdulaziz Medical City, Riyadh, Saudi Arabia
Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, LRCP is a member of the following medical societies: American Institute of Ultrasound in Medicine, Radiological Society of North America, Royal College of Physicians, Royal College of Physicians and Surgeons of the United States, Royal College of Radiologists, and Royal College of Surgeons of England
Disclosure: Nothing to disclose.

Coauthor(s)

Muthusamy Chandramohan, MBBS, DMRD, FRCR, Consultant Radiologist, Bradford Teaching Hospitals, UK
Disclosure: Nothing to disclose.

Sumaira MacDonald, MBChB, PhD, MRCP, FRCR, Lecturer, Sheffield University Medical School; Endovascular Fellow, Sheffield Vascular Institute
Sumaira MacDonald, MBChB, PhD, MRCP, FRCR is a member of the following medical societies: British Medical Association, Royal College of Physicians, and Royal College of Radiologists
Disclosure: Nothing to disclose.

Medical Editor

Robert J Starshak, MD, Medical Director, Assistant Clinical Professor, Department of Radiology, Medical College of Wisconsin, Falls Medical Group
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

David A Stringer, BSc, MBBS, FRCR, FRCPC, Professor, National University of Singapore; Head, Diagnostic Imaging, KK Women's and Children's Hospital, Singapore
David A Stringer, BSc, MBBS, FRCR, FRCPC is a member of the following medical societies: British Columbia Medical Association, Canadian Association of Radiologists, European Society of Paediatric Radiology, Ontario Medical Association, Radiological Society of North America, Royal College of Physicians and Surgeons of Canada, Royal College of Radiologists, and Society for Pediatric Radiology
Disclosure: None None None

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

John Karani, MBBS, FRCR, Consulting Staff, Department of Radiology, King's College Hospital, London
Disclosure: Nothing to disclose.

 
 
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