Appendiceal carcinoid mimicking a Meckel's diverticulum on Tc-99m pertechnetate imaging

Obscured Meckel's Diverticulum by the Urinary Bladder: The Value of Lateral View and Post Void Images

We describe a case of a 5-year-old boy with a history of intermittent melena underwent TcO4 scintigraphy. On dynamic images, no abnormal activity was noted. After voiding and also in the lateral view, the focus of activity was noted in the superior and anterior aspect of the urinary bladder, compatible with a Meckel's diverticulum, which was confirmed pathologically as well.

Similar Appearance on Dynamic Images of Meckel Scintigraphy Caused by Different Etiologies: The Value of Lateral Views

Positive gastric mucosa Meckel diverticulum generally shows nonmoving activity in the right abdomen, which appears early in the study at about the same time of the appearance of the stomach. However, a stoma from ileostomy can result in similar findings on dynamic images. The difference between a true Meckel diverticulum and stoma can be exposed by lateral views.

The Coexistence of a Horseshoe Kidney and Meckel Diverticulum With Dramatic Mobility Revealed Through 99mTc Pertechnetate Imaging

A previously healthy 11-year-old boy with intermittent abdominal pain and bloody stool underwent Meckel scintigraphy. On the initial images, there was a faint U-shaped activity in the mid-abdominal region, which gradually faded and evolved into distinct foci of radiotracer accumulation in the later images. One of the foci changed its location during the study, suspected as moving Meckel diverticulum. A horseshoe kidney was noted by subsequent CT images, which corresponded to nonmoving foci. A Meckel diverticulum was confirmed after exploratory laparotomy, accounted for moving focus on Merkel scintigraphy.

Elongated Appearance of Meckel's Diverticulum on 99mTcO4 Scintigraphy

A Meckel's scintigraphy using TcO4 was performed in a 9-year-old boy. The images revealed an elongated abnormal radiotracer accumulation in the right abdomen, which was confirmed as Meckel diverticulum combined with an omphalomesenteric cyst.

Aspiration Incidentally Detected by a Meckel Scintigraphy

Meckel scintigraphy with Tc-pertechnetate was performed in a 5-year-old boy to determine whether a Meckel diverticulum containing ectopic gastric mucosa caused bleeding. The images did not reveal focal activity characteristic of a Meckel diverticulum. Unexpectedly, activity in the tracheobronchial tree was visualized, consistent with aspiration of the radioactive saliva.

Horseshoe Kidney Incidentally Revealed on Meckel Scintigraphy

An 8-year-old male patient with history of bloody stools underwent a Meckel diverticulum scintigraphy to evaluate for ectopic gastric mucosa. The static images showed 2 abnormal foci of radiotracer accumulation in the mid-abdomen. Contrary to the renal activity, the foci appeared more prominent on the anterior view and localized anteriorly to the expected kidneys location on the left lateral view. Carefully reviewed dynamic acquisition revealed faint catenary-shaped activity in this region on earlier images, gradually evolving into 2 prominent foci on later images. A horseshoe kidney was suspected, the pathology being confirmed by abdominal ultrasonography.

Dual pathology in a patient with right lower quadrant pain

Meckel diverticula are remnants of the omphalomesenteric duct. They have 2% incidence in the general population, are usually asymptomatic, and tend to be diagnosed incidentally. The generally held principle had been that asymptomatic cases do not require resection, as exemplified by a 2008 systematic review of over 200 studies. However, a recent series reported an increased risk of malignancies, and recommended mandatory resection. We present a case of Meckel diverticulitis with concurrent infiltrative appendiceal carcinoid in a patient with right lower quadrant pain.

Rectal juvenile polyp detected on (99m)Tc-pertechnetate abdominal scintigraphy (Meckel scan)

An 8-year-old boy presented with first episode of rectal bleeding. Initial hemoglobin was 9 g/dL. A Meckel scan showed a hyperemic focus in the lower pelvis. Colonoscopy identified a juvenile polyp with dysplasia in the rectosigmoid region. It is important to carefully evaluate the dynamic flow images in the Meckel scan because pathology other than a Meckel diverticulum may be identified.