gastrointestinal disorders
Meckel Diverticulum
Diagnosis of Meckel Diverticulum
Based on symptoms For bleeding: Radionuclide scan, wireless capsule endoscopy, and enteroscopy For pain: CT Diagnosis of Meckel diverticulum is often difficult, and tests are chosen based on presenting symptoms. Ifrectal bleedingis suspected to originate from a Meckel diverticulum, a Tc-99m pertechnetate scan (Meckel scan) may identify ectopic gastric mucosa and thus the diverticulum in 85 to 97% of bleeding children. Diverticula without heterotopic gastric mucosa are not detectable on a Meckel scan. Wireless capsule endoscopy and enteroscopy can visually identify the diverticulum as the source of bleeding. Patients presenting withabdominal painand focal tenderness should have CT with oral contrast. If vomiting and colicky abdominal pain predominate, flat and upright x-rays of the abdomen can be done to diagnose obstruction. Definitive diagnosis is occasionally made only during surgical exploration for presumed appendicitis; whenever a normal appendix is found during exploration for suspected appendicitis, a Meckel diverticulum should be sought. 