Meckel’s Diverticulum

  • S. T. Treves
  • Richard Grand


The primary application of technetium-99m (Tc-99m) pertechnetate scintigraphy of the abdomen is in the diagnosis of Meckel’s diverticulum. Abdominal scintigraphy with the pertechnetate anion (Tc-99mO 4 ) was initially proposed for identifying Meckel’s diverticula containing gastric mucosa by Harden et al.21 and was subsequently introduced into clinical practice for this purpose by Jewett et al.30 in 1970. Since then, many reports have demonstrated the safety and effectiveness of the examination. An excellent two-part review of the subject has been written by Sfakianakis and Conway.6364 Because Meckel’s diverticulum cannot be diagnosed reliably by other imaging methods,6,14,17,46 radiopertechnetate scintigraphy is currently the best nonoperative method of definitive diagnosis for this condition. The radiation exposure is approximately equivalent to 20 sec of radiographic fluoroscopy.12


Gastric Mucosa Barium Enema Ectopic Gastric Mucosa Sodium Pertechnetate Angiographic Demonstration 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Anderson GF, Sfakianakis GN, King DR, Boles ET Jr. Hormonal enhancement of technetium-99m pertechnetate uptake in experimental Meckel’s diverticulum. J Pediatr Surg 1980; 15: 900–5.PubMedCrossRefGoogle Scholar
  2. 2.
    Berquist TH, Nolan NG, Adson MA, Shutt AJ. Diagnosis of Meckel’s diverticulum by radioisotope scanning. Mayo Clin Proc 1973; 48: 98–102.PubMedGoogle Scholar
  3. 3.
    Berquist TH, Nolan NG, Carlson HC, Stephens DH. Diagnosis of Barrett’s esophagus by pertechnetate scintigraphy. Mayo Clin Proc 1973; 48: 2769.Google Scholar
  4. 4.
    Berquist TH, Nolan NG, Stephens DH, Carlson HC. Radioisotope scintigraphy in diagnosis of Barrett’s esophagus. AJR 1975; 123: 401–11.CrossRefGoogle Scholar
  5. 5.
    Berquist TH, Nolan NG, Stephens DH, Carlson HC. Specificity of Tc-99m pertechnetate in scintigraphic diagnosis of Meckel’s diverticulum: review of 100 cases. J Nucl Med 1976; 17: 465–9.PubMedGoogle Scholar
  6. 6.
    Bree RL, Reuter SR. Angiographic demonstration of a bleeding Meckel’s diverticulum. Radiology 1973, 108: 287–8.PubMedGoogle Scholar
  7. 7.
    Broca M, Bach CH, Sedgrez A. Hemorragies intestinales: contribution a la detection des heterotopies de muqueuse gastrique et du diverticule de Meckel: interet de scintigramme gastrinque. Chirurgie 1972; 98: 649–52.Google Scholar
  8. 8.
    Canty T, Meguid MM, Eraklis AJ. Perforation of Meckel’s diverticulum scan (letter to the editor). Surgery 1972; 71: 313.Google Scholar
  9. 9.
    Chaudhuri TK. Cellular site of secretion of 99mTc04 in the stomach-a controversial point (letter to the editor). J Nucl Med 1975; 16: 1204–5.PubMedGoogle Scholar
  10. 10.
    Chaudhuri TK, Polak, JJ. Autoradiographic studies of distribution in the stomach of Tc-99m pertechnetate. Radiology 1977; 123: 223–4.PubMedGoogle Scholar
  11. 11.
    Chaudhuri TK, Chaudhuri TK, Christie JH. False positive Meckel’s diverticulum scan (letter to the editor). Surgery 1972; 71: 313.PubMedGoogle Scholar
  12. 12.
    Conway JJ. Radionuclide diagnosis of Meckel’s diverticulum. Gastrointest Radiol 1980; 5: 209–13.PubMedCrossRefGoogle Scholar
  13. 13.
    Conway JJ, and the Pediatric Nuclear Club of the Society of Nuclear Medicine. The sensitivity, specificity and accuracy of radionuclide imaging of Meckel’s diverticulum (abstract). J Nucl Med 1976; 17: 553.Google Scholar
  14. 14.
    Dalinka MK, Wunder JF. Meckel’s diverticulum and its complications, with emphasis on roentgen ologic demonstration. Radiology 1973; 106: 295–8.PubMedGoogle Scholar
  15. 15.
    DeBartolo HM, van Heerden JA. Meckel’s diver ticulum. Ann Surg 1976; 183: 30–33.PubMedCrossRefGoogle Scholar
  16. 16.
    Duszynski DO, Jewett TC, Allen JE. 99mTc per technetate scanning of the abdomen with particular reference to small bowel pathology. AJR 1971; 113: 258–62.CrossRefGoogle Scholar
  17. 17.
    Faris JC, Whitley JE. Angiographic demonstration of Meckel’s diverticulum. Radiology 1973; 108: 285–6.PubMedGoogle Scholar
  18. 18.
    Feggi LM, Bighi SM. Technical notes for scintigraphy of Meckel’s diverticulum. J Nucl Med 1979;Google Scholar
  19. 19.
    Gelfand MJ, Silberstein EB, Cox J. Radionuclide imaging of Meckel’s diverticulum. Angiographic demonstration. Radiology 1976; 120: 327–8.Google Scholar
  20. 20.
    Gershater R. Enterolith causing bleeding in a pa tient with Meckel’s diverticulum. Angiographic demonstration. Radiology 1976; 120: 327–8.PubMedGoogle Scholar
  21. 21.
    Harden RMG, Alexander WD, Kennedy I. Isotope uptake and scanning of stomach in man with Tc-99m pertechnetate. Lancet 1967; i:1305–7.Google Scholar
  22. 22.
    Harper PV, Andros G, Lathrop K. Preliminary ob servations on the use of six hour Tc-99m as a tracer in biology and medicine. Argonne Cancer Research Hospital Semiannual Report to the AEC, No. 18, Office of Technical Services, Dept. of Commerce, Washington, D.C. 1962; 76–88.Google Scholar
  23. 23.
    Harper PV, Lathrop KA, Jiminez F, Fink R, Gotts chalk A. Technetium-99m as a scanning agent. Ra diology 1965; 85: 101–8.Google Scholar
  24. 24.
    Hildamus F. Cited by Neff G. Sas Meckelsche Divertikel. Ergeb Chir Orthop 1937; 30: 227–315.Google Scholar
  25. 25.
    Ho JE, Konieczny KM. The sodium pertechnetate Tc-99m scan: an aid in the evaluation of gastroin testinal bleeding. Pediatrics 1975; 56: 34–40.PubMedGoogle Scholar
  26. 26.
    Ho JE, Gleason WA, Thompson JS. The expanding spectrum of disease demonstrable by Tc-99m per technetate abdominal imaging (abstract). J Nucl Med 1978; 19: 691.Google Scholar
  27. 27.
    Hofmeyr NG. Stomach scanning after intravenous Tc-99m administration. A preliminary report. South Afr Med J 1967; 41: 572–5.Google Scholar
  28. 28.
    Holder LE, Ashare AB, Smith W, Saenger E. Pentagastrin: a new drug for stimulating gastric secretion of pertechnetate (abstract). J Nucl Med 1975; 16: 535–6.Google Scholar
  29. 29.
    Jaros R, Schussheim A, Levy LM. Preoperative diagnosis of bleeding Meckel’s diverticulum utilizing technetium-99m pertechnetate scintiimaging. in der Magen schleimhaut. Ein Beitrag sur Methodik der Mik rohistoautoradiographie wasserloslicher Isotope. Histochemie 1969; 19: 147–54.CrossRefGoogle Scholar
  30. 30.
    Jewett TC Jr., Duszynski DO, Allen JE. The visu-alization of Meckel’s diverticulum wiht Tc-9m pertechnetate. Surgery 1970; 68: 567–70.PubMedGoogle Scholar
  31. 31.
    Jewett TC Jr., Lebowitz R, Treves S. Search for Meckel’s diverticulum (letter to the editor and response). Surgery 1972; 72: 492–3.Google Scholar
  32. 32.
    Johnson LR. The trophic action of gastrointestinal hormones. Gastroenterology 1976; 70: 278–88.PubMedGoogle Scholar
  33. 33.
    Keramidas DC, Coran AG, Zaleska RW. An experimental model for assessing the radiopertech-netate diagnosis of gastric mucosa in Meckel’s di-verticulum. J Pediatr Surg 1974; 9: 879–83.PubMedCrossRefGoogle Scholar
  34. 34.
    Khettry J, Effmann E, Grand RJ, Treves S. Effect of pentagastrin, histalog, glucagon, secretin and perchlorate on the gastric handling of Tc-99m-per-technetate in mice. Radiology 1976; 120: 629–31.Google Scholar
  35. 35.
    Kilpatrick JM. Scanning in diagnosis of Meckel’s diverticulum. Hosp Pract 1974; 9: 131–8.Google Scholar
  36. 36.
    Kilpatrick ZM, Aseron CA. Radioisotope detection of Meckel’s diverticulum causing acute renal hemorrhage. N Engl J Med 1972; 287: 653–4.PubMedCrossRefGoogle Scholar
  37. 37.
    Lathrop KA, Harper PV. Biologic behavior of 99’ Tc from 99mTc pertechnetate ion. Prog Nucl Med 1972; 1: 145–62.PubMedGoogle Scholar
  38. 38.
    Leonidas JC, Germann DR. Technetium-99m per-technetate imaging in diagnosis of Meckel’s diverticulum. Arch Dis Child 1974; 49: 21–26.PubMedCrossRefGoogle Scholar
  39. 39.
    Loken MK, Telander GT, Salmon RJ. Technetium-99m compounds for visualization of body organs. JAMA 1972; 194: 152–6.CrossRefGoogle Scholar
  40. 40.
    Lunia S, Lunia C, Chandramouly B, Chodos RB. Radionuclide meckelogram with particular reference to false-positive results. Clin Nucl Med 1979; 4: 285–8.PubMedCrossRefGoogle Scholar
  41. 41.
    Mark R, Young L, Ferguson C, Sutherland JB. Diagnosis of an intrathoracic gastrogenic cyst using Tc-99m-pertechnetate. Radiology 1973; 109: 137–138PubMedGoogle Scholar
  42. 42.
    Marsden DS, Priebe CJ. Preliminary appraisal of present Tc-99m-pertechnetate techniques for detecting ectopic gastric mucosa. Radiology 1974; 113: 459–60.PubMedGoogle Scholar
  43. 43.
    Martin GI, Kutner FR, Moses L. Diagnosis of Meckel’s diverticulum by radioisotope scanning. Pediatrics 1976; 57: 11–12.PubMedGoogle Scholar
  44. 44.
    Case records of the Massachusetts General Hospital. Case 16–1980: duplication of ileum with ectopic gastric mucosa and peptic ulceration with perforation. N Engl J Med 1980; 302: 958–62.CrossRefGoogle Scholar
  45. 45.
    Meckel JF. Veber die Diverticel am darmkanal. Arch Physiol 1809; 9: 421.Google Scholar
  46. 46.
    Meguid MM, Wilkinson RH, Canty T, Eraklis AJ, Treves S. Futility of barium sulfate in diagnosis of bleeding Meckel diverticulum. Arch Surg 1974; 108: 361–2.PubMedCrossRefGoogle Scholar
  47. 47.
    Meier-Ruge W, Fridrich R. Die Verteilung von diatr 1973; 82:45–49. Technetium-99m and Jod-131 Diagnosis of a bleeding Meckel’s diverticulum using radiopertechnetate. Am J Gastroenterol 1977; 67: 235–9.Google Scholar
  48. 48.
    Moss AA, Kressel HY. Intestinal infarction: current problems and new methods of diagnosis using radionuclide scans. Appl Radio! Nucl Med 1976; 156–60.Google Scholar
  49. 49.
    Muroff LR, Casarella WJ, Johnson PM. Preoper 1981; 22:647–54. ative diagnosis of Meckel’s diverticulum: angio graphic and radionuclide studies in an adult. JAMA 1974; 229: 1900–2.PubMedCrossRefGoogle Scholar
  50. 50.
    Necheles H, Sporn J, Walker L. Effect of glucagons on gastrointestinal motility. Am J Gastroenterol 1966; 45: 34–39.PubMedGoogle Scholar
  51. 51.
    Oldendorf WH, Sisson WB, Iisaka Y. Compart mental redistribution of 99mTc-pertechnetate in the presence of perchlorate ion and its relation to plasma protein binding. J Nucl Med 1970; 11: 85PubMedGoogle Scholar
  52. 52.
    Petrokubi JR, Baum S, Rohrer GV. Cimetidine administration resulting in improved pertechnetate imaging of Meckel’s diverticulum. Clin Nucl Med 1978; 3: 385–8.PubMedCrossRefGoogle Scholar
  53. 53.
    Polga JP. Nasogastric suction to improve gastroin testinal scanning. J Nucl Med 1974; 15: 374.PubMedGoogle Scholar
  54. 54.
    Polga JP, Sargent J, Dickinson P. Positive intestinal scan caused by carcinoid tumor. J Nucl Med 1974; 15: 365–6.PubMedGoogle Scholar
  55. 55.
    Priebe CJ Jr., Marsden DS, Lazarevic B. The use of 99mtechnetium pertechnetate to detect trans planted gastric mucosa in the dog. J Pediatr Surg 1974; 9: 605–12.PubMedCrossRefGoogle Scholar
  56. 56.
    Rodgers BM, Youssef S. “False positive” scan for Meckel diverticulum. J Pediatr 1975; 87: 239PubMedCrossRefGoogle Scholar
  57. 57.
    Rosenthal! L, Henry JN, Murphy DA, Freeman L. Radiopertechnetate imaging of the Meckel’s diver ticulum. Radiology 1972; 105: 371–3.Google Scholar
  58. 58.
    Rutherford RB, Akers DR. Meckel’s diverticulum: 19: 381–3.Google Scholar
  59. 59.
    Sagar VV, Piccone JM. The gastric uptake and secretion of Tc-99m pertechnetate after H2 receptor blockage in dogs (abstract). J Nucl Med 1980; 21: P67.Google Scholar
  60. 60.
    the esophagus (letter to the editor). J Nucl Med 1978; 19: 1366–7.Google Scholar
  61. 61.
    Seitz W, Keim HJ, Hahn K. Abdominal scintigraphy for diagnosis of intestinal bleeding. World J Surg 1978; 2: 613–9.PubMedCrossRefGoogle Scholar
  62. 62.
    Seltzer MH, Conte PJ Jr, Rickert RR, Singer M. special Campbell JB. Techne reference to the pattern of bleeding and to mesodi verticular vascular bands. Surgery 1966; 59: 618Google Scholar
  63. 63.
    Sfakianakis GN, Conway JJ. Detection of ectopic gastric mucosa in Meckel’s diverticulum and in other aberrations by scintigraphy: I. Pathophysiology and 10-year clinical experience. J Nucl MedGoogle Scholar
  64. 64.
    Sfakianakis GN, Conway JJ. Detection of ectopic gastric mucosa in Meckel’s diverticulum and in other aberrations by scintigraphy: II. Indications and methods. A 10-year experience. J Nucl Med 1981; 22: 732–8.PubMedGoogle Scholar
  65. 65.
    Sfakianakis GN, Anderson GF, King DR, Boles ET Jr. The effect of gastrointestinal hormones on the pertechnetate imaging of ectopic gastric mucosa in experimental Meckel’s diverticulum. J Nucl Med 1981; 22: 678–83.PubMedGoogle Scholar
  66. 66.
    Siddiqui A, Ryo UY, Pinsky SM. Arteriovenous malformation simulating Meckel’s diverticulum on Tc-99m-pertechnetate abdominal scintigraphy. Radiology 1977; 122: 173–4.PubMedGoogle Scholar
  67. 67.
    Singh PR, Russel CD, Dubovsky EV, Bridges WM. Technique of scanning for Meckel’s diverticulum. Clin Nucl Med 1978; 3: 188–92.PubMedCrossRefGoogle Scholar
  68. 68.
    Tauscher JW, Bryant DR, Gruenther RC. False-positive scan for Meckel diverticulum. J Pediatr 1978; 92: 1022–3.PubMedCrossRefGoogle Scholar
  69. 69.
    Taylor AT Jr, Alazraki N, Henry JE. Intestinal concentration of 99m Tc-pertechnetate into isolated loops of rat bowel. J Nucl Med 1976; 17: 470–2.PubMedGoogle Scholar
  70. 70.
    Treves S, Grand RJ, Eraklis AJ. Pentagastrin stimulation of technetium 99m uptake by ectopic gastric mucosa in a Meckel’s diverticulum. Radiology 1978; 128: 711–2.PubMedGoogle Scholar
  71. 71.
    Wang TST, Fawwaz RA, Esser PD, Johnson PM. Altered body distribution of (99mTc) pertechnetate a review of 148Google Scholar
  72. 72.
    Wilson JP, Wenzel WW, tium scans in the detection of gastrointestinal hemorrhage. Preoperative diagnosis of enteric duplication in an infant. JAMA 1977; 237: 265–6.PubMedCrossRefGoogle Scholar
  73. 73.
    Wine CR, Nahrwold DL, Waldhausen JA. Role of the technetium scan in the diagnosis of Meckel’s diverticulum. J Pediatr Surg 1974; 9: 855–88.CrossRefGoogle Scholar
  74. 74.
    Wine CR, Nahrwold DL, Rose RC, Miller KL. Effect of histamine on technetium-99m excretion by gastric mucosa. Surgery 1976; 80: 591–4.PubMedGoogle Scholar
  75. 75.
    Winter PF. Cellular site of 99mTcO4 secretion in the stomach (letter to the editor). J Nucl Med 1976; 17: 756PubMedGoogle Scholar
  76. 76.
    Winter PF. Sodium pertechnetate Tc-99m scanning of the abdomen. Diagnosis of an ileal duplication cyst. JAMA 1977; 237: 1352–3.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1985

Authors and Affiliations

  • S. T. Treves
  • Richard Grand

There are no affiliations available

Personalised recommendations