Experiences with detection of the ectopic gastric mucosa by means of Tc-99m pertechnetate disodium scintigraphy in children with lower gastrointestinal bleeding.
OBJECTIVE
We report our experience of the detection of ectopic gastric mucosa by means of perfusion Tc-99m pertechnetate disodium scintigraphy in patients with lower gastrointestinal bleeding. Gastric mucosa may be present in Meckel's diverticulum and is associated with peptic ulcer disease and lower gastrointestinal (GI) bleeding; Tc-99m pertechnetate scintigraphy can help to make the diagnosis of ectopic gastric mucosa.


METHODS
Seventy-nine children (40 boys, 39 girls, aged 1 - 17, mean age 8 years) underwent Tc-99m pertechnetate scintigraphy in the last thirteen years. All patients had melena or hematochezia. Morphology imaging and endoscopy were negative in all patients. Dynamic scintigraphy of the abdomen was started immediately after i. v. administration of Tc-99m pertechnetate. The static image of the abdomen was performed subsequently. Where necessary, SPECT was additionally performed to improve the sensitivity, specificity and spatial specification.


RESULTS
Three patients (two boys: two and ten years old; one girl: four years old) had positive scintigraphy results. All 3 patients underwent surgery and Meckel's diverticulum with ectopic gastric mucosa found (histology). GI bleeding stopped spontaneously in patients with a negative scintigraphy. These patients did not undergo intraoperative enteroscopy or surgery.


CONCLUSIONS
Tc-99m pertechnetate scintigraphy can help to detect ectopic gastric mucosa in the abdomen and improve the management of patients with lower gastrointestinal bleeding.
Dolezal
J
J
Department of Nuclear Medicine, University Hospital, Hradec Kralove, Czech Republic. dolezal@fnhk.cz
Vizda
J
J
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002828:Choristoma / Q000000981:diagnostic imaging*; D002927:Cimetidine; D005260:Female; D005753:Gastric Mucosa; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology; D006635:Histamine H2 Antagonists; D006801:Humans; D007089:Image Enhancement; D007223:Infant; D008297:Male; D008467:Meckel Diverticulum / Q000150:complications / Q000175:diagnosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D011899:Ranitidine; D013670:Sodium Pertechnetate Tc 99m
D006635:Histamine H2 Antagonists; D019275:Radiopharmaceuticals; D002927:Cimetidine; D011899:Ranitidine; D013670:Sodium Pertechnetate Tc 99m