The significance of Meckel's scan in pediatric gastrointestinal bleeding cases: A case report

Meckel's diverticulum is the most prevalent congenital anomaly of the gastrointestinal tract, identified in 2% of the population according to autopsy studies. Most patients remain asymptomatic throughout their lives and are typically diagnosed when complications arise. The diagnosis can be challenging, but imaging is crucial for promptly identifying and distinguishing it from other conditions that have similar clinical manifestations. A 13-year-old male was admitted with a 5-day history of rectal bleeding. The patient continued to experience painless gastrointestinal bleeding, indicating the performance of a Tc-99m pertechnetate scintigraphy or Meckel's scan. Planar images revealed focal uptake within the right hemiabdomen, suggestive of the presence of a Meckel's diverticulum. Subsequent laparotomy surgery confirmed the presence of a Meckel's diverticulum located 50 cm from the ileocecal valve. Histopathological examination of the resected specimen confirmed Meckel's diverticulum with ectopic gastric mucosa. This patient with Meckel's diverticulum exhibited minimal abdominal symptoms, and there were no other complications such as intussusception, which could lead to bowel obstruction. Technetium-99m pertechnetate scintigraphy is a common method for evaluating children with unexplained gastrointestinal tract bleeding. SPECT/CT fusion imaging enables the simultaneous fusion of functional and anatomical information, preventing false-negative scintigraphy examinations. Its capability to precisely localize activity in abnormal structures contributes to accurate scan interpretation. Complications of Meckel's diverticulum are uncommon and pose a diagnostic challenge. Through comprehensive history-taking, physical examination, and nuclear imaging, the diagnosis can be identified, and surgical intervention can be performed to achieve the best possible outcome for the patient.