Abstract
Technetium-99m (99mTc) pertechnetate scintigraphy in a child with acute gastrointestinal bleeding of unknown origin suggests ectopic gastric mucosa caused by Meckel’s diverticulum or gastrointestinal duplication cysts. Our objective was to define the patterns of scintigraphic findings likely to be encountered in patients with ectopic gastric mucosa with illustrative cases and to review the literature. Fifty children (age 1 year to 14 years) were evaluated for ectopic gastric mucosa using 99mTc pertechnetate scintigraphy. Functioning ectopic gastric mucosa was detected in eight patients with Meckel’s diverticula and three patients with bowel duplication. Three patients showed atypical findings on scintigraphy which were perforated appendix, calyceal stasis, and regional enteritis. Ectopic functioning gastric mucosa in Meckel’s diverticulum is visualized simultaneously with the stomach, whereas in intestinal duplications tracer activity can be visualized in the dynamic sequence or before gastric tracer visualization in an irregular pattern. A variety of scintigraphic patterns can be found in patients with ectopic gastric mucosa undergoing 99mTc pertechnetate scintigraphy depending on the location and size of the ectopic tissue. Also, acquisition of delayed images is useful when the initial images are equivocal in children.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Amoury RA, Snyder CL. Meckel diverticulum. In: O’Neill JA, Rowe MI, Grosfeld JL, et al., editors. Pediatric surgery. St. Louis: Mosby-Year Book; 1998, p. 1173–1184.
Sfakianakis GN, Haase GM. Abdominal scintigraphy for ectopic gastric mucosa: a retrospective analysis of 143 studies. Am J Roentgenol 1982;138:7–12.
Sfakianakis GN, Conway JJ. Detection of ectopic gastric mucosa in Meckel’s diverticulum and in other abnormalities by scintigraphy. II. Indications and methods: a 10-year experience. J Nucl Med 1981;22:732–738.
Kong MS. Technetium pertechnetate scan for ectopic gastric mucosa in children with gastrointestinal bleeding. J Formos Assoc 1993;92:717–720.
Fries M, Mortensson W, Robertson B. Technetium pertechnetate scintigraphy to detect ectopic gastric mucosa in Meckel’s diverticulum. Acta Radiol Diagn 1984;25:417–422.
Dixon PM, Nolan DJ. The diagnosis of Meckel’s diverticulum: a continuing challenge. Clin Radiol 1987;38:615–619.
Schwartz MJ, Lewis JH. Meckel’s diverticulum pitfalls in scintigraphic detection in the adult. Am J Gasteroenterol 1984;79:611–618.
Luckier LS, Dohan O, Li Y, Chang CJ, Carrasco N, Dadachova E. Kinetics of perrhenate uptake and comparative biodistribution of perrhenate, pertechnetate and iodide by NaI symporter-expressing tissues in vivo. J Nucl Med 2004;45:500–507.
Hill P, Rode J. Helicobacter pylori in ectopic gastric mucosa in Meckel’s diverticulum. Pathology 1998;30:7–9.
Morris A, Nicholson G, Zwi J, Vanderwee M. Campylobacter pylori infection in Meckel’s diverticula containing gastric mucosa. Gut 1989;30:1233–1235.
Maggi G, Navarra L, Cianca G, Vittorini V, Ciccarelli O, Pietroletti R, et al. Ectopic pancreas in Meckel’s diverticulitis: a description of a new clinical case. Ann Ital Chir 2002;73:647–649.
Artigas V, Calabuig R, Badia F, Rius X, Allende L, Jover J. Meckels diverticulum: value of ectopic tissue. Am J Surg 1986;151:631–634.
Gross RE, Holcomb GW Jr, Farber S. Duplications of the alimentary tract. Pediatrics 1952;9:449–452.
Holcomb GW III, Gheissari A, O’Neill JA Jr, Shorter NA, Bishop HC. Surgical management of alimentary tract duplications. Ann Surg 1989;209:167–174.
Bond SJ, Groff DB. Gastrointestinal duplications. In: O’Neill JA Jr, Rowe MI, Grosfeld JL, Fonkalrud EW, Coran AG, editors. Pediatric surgery, vol. 2, 5th ed. St Louis: Mosby; 1998. p. 1257–1267.
Kumar R, Tripathi M, Chandrashekar N, Agarwala S, Kumar A, Dasan JB, et al. Diagnosis of ectopic gastric mucosa using 99mTc pertechnetate: spectrum of scintgraphic findings. Br J Radiol 2005;78:714–720.
Jewett TC, Duscynski DO, Allen JE. The visualisation of Meckel’s diverticulum with Tc-99m pertechnetate. Surgery 1970;68:567–570.
Treves S, Grand RJ, Eraklsi AJ. Pentagastrin stimulation of 99mTc uptake by ectopic gastric mucosa in a Meckel’s diverticulum. Radiology 1978;128:711–712.
Diamond RH, Rothstein RD, Alavi A. The role of simetidine enhanced 99mTc pertechnetate imaging for visualising Meckels diverticulum. J Nucl Med 1991;16:1422–1424.
Sfakianakis GN, Anderson GF, King DR, Boles ET. The effect of gastrointestinal hormones on the pertechnetate imaging of ectopic gastric mucosa in experimental Meckel’s diverticulum. J Nucl Med 1981;22:678–683.
Chaudhuri TK, Chaudhuri TK, Christie JH. False positive Meckel’s scan. Surgery 1972;71:313.
Fink-Bennett D. The uterine blush: a potential false-positive in Meckel’s scan interpretation. Clin Nucl Med 1982;7:444.
Berquist TH, Nolan NG, Stephens DH, Carlson HC. Specificity of 99mTc pertechnetate in scintigraphic diagnosis of Meckel’s diverticulum: review of 100 cases. J Nucl Med 1976;17:465–469.
Connoly L, Treves T, Bozorgi F, O’Connor SC. Meckel’s diverticulum: demonstration of heterotropic gastric mucosa with Tc-99m pertechnetate SPECT. J Nucl Med 1998;39:1458–1460.
Ford PV, Bartold SP, Fink-Bennett D, Lull RJ, Maurer AH, Seabold JE. Society of Nuclear Medicine Procedure Guidelines for Gastrointestinal Bleeding and Meckel’s Diverticulum Scintigraphy Society of Nuclear Medicine Procedure Guidelines Manual. June 2002.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kiratli, P.O., Aksoy, T., Bozkurt, M.F. et al. Detection of ectopic gastric mucosa using 99mTc pertechnetate: review of the literature. Ann Nucl Med 23, 97–105 (2009). https://doi.org/10.1007/s12149-008-0204-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12149-008-0204-6