The value of sodium pertechnetate Tc99m scans in the diagnosis of Meckel's diverticulum.
A retrospective study was conducted of our experience with sodium pertechnetate Tc99m scans for diagnosing suspected Meckel's diverticula. Seventy-seven cases scanned between 1979 and 1994 were reviewed. Eighty per cent of the group presented with bleeding per rectum, 12% with pain, and 6.5% with anaemia. Ten scans were positive with 7 true-positive and 3 false-positive. Of the 67 negative scans, 3 were false-negatives. There were six Meckel's diverticuli and four duplication cysts between the true-positive and false-negative groups. All presented with major gastrointestinal (GI) bleeding and gastric mucosa was identified on histology. The three false-positive cases had inappropriate laparotomies on the basis of scan results. The test sensitivity was 70% with a specificity of 95%, giving an overall accuracy of 92%. The Meckel's scan is a useful investigation for GI bleeding in children. Surgical intervention should be guided by the full clinical picture and the scan, rather than the scan result alone.
Department of Paediatric Surgery, Institute of Child Health and University of Cape Town, Red Cross War Memorial Children's Hospital, 7700, Rondebosch, South Africa.
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S
McCulley
A J
AJ
Millar
M D
MD
Mann
H
H
Rode
R A
RA
Brown