Imaging
Meckel's Diverticulum
- Preliminary Diagnosis: Meckel's Diverticulum
-
I. What imaging technique is first-line for this diagnosis
- II. Describe the advantages and disadvantages of this technique for diagnosis of Meckel's diverticulum.
-
III. What are the contraindications for the first-line imaging technique?
-
IV. What alternative imaging techniques are available?
- V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of Meckel's diverticulum.
- VI. What are the contraindications for the alternative imaging techniques?
Preliminary Diagnosis: Meckel's Diverticulum
I. What imaging technique is first-line for this diagnosis
Radiopharmaceutical technetium-99m pertechnetate
II. Describe the advantages and disadvantages of this technique for diagnosis of Meckel's diverticulum.
Advantages
Meckel scan is a diagnostic evaluation with high specificity
Disadvantages
False negative results may be due to lack or minimal gastric mucosa in the diverticulum, rapid washout, or impaired blood supply.
False positive results may be due to ectopic gastric mucosa, inflammation, and vascular malformations.
Normal small bowel activity can be confused with a Meckel’s diverticulum.
Use of ionizing radiation.
III. What are the contraindications for the first-line imaging technique?
Pregnancy is a relative contraindication with use of ionizing radiation.
IV. What alternative imaging techniques are available?
CT with oral contrast
V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of Meckel's diverticulum.
CT with oral contrast
Advantages
Relatively quick imaging procedures that require minimal patient cooperation and are less susceptible to motion artifact
Disadvantages
A Meckel’s diverticulum suspected on CT is likely an incidental finding and may be confirmed with a Meckel scan if clinically indicated.
CT imaging is not a sensitive test to detect a Meckel’s diverticulum.
Findings may be confused with appendicitis.
For pregnant women, ultrasound is the first choice of imaging.
VI. What are the contraindications for the alternative imaging techniques?
CT with oral contrast
Contraindicated in pregnant women, especially within the first two trimesters
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