title: Gastrointestinal bleeding in adult patients with Meckel's diverticulum: the role of technetium 99m pertechnetate scan.
abstract: Obscure gastrointestinal (GI) bleeding is often challenging for the primary care physician, but with improved diagnostic testing the cause of this blood loss is determined in most patients. However, approximately 5% of the time no underlying cause is found. One common etiology in patients younger than 40 years of age is a Meckel's diverticulum. The technetium 99m pertechnetate scan is the standard test for making this diagnosis. However, the sensitivity of the scan is only 62% in the adult population. In this case report, a patient with profound, hemodynamically significant GI blood loss had multiple negative studies. Subsequently, an abnormal vascular lesion was detected and during exploratory laparotomy, a Meckel's diverticulum was found and removed. Although the technetium pertechnetate scan is falsely negative in a number of cases, there are ways to increase its sensitivity and possibly avoid repeated testing.
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: Sauyu
authors.initials: S
authors.lastname: Lin
authors.forename: Paul V
authors.initials: PV
authors.lastname: Suhocki
authors.forename: Kirk A
authors.initials: KA
authors.lastname: Ludwig
authors.forename: Michael A
authors.initials: MA
authors.lastname: Shetzline
mesh_terms: D000328:Adult; D005188:False Negative Reactions; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D008297:Male; D008467:Meckel Diverticulum / Q000150:complications / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013670:Sodium Pertechnetate Tc 99m; D014055:Tomography, Emission-Computed / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D013670:Sodium Pertechnetate Tc 99m