Delayed imaging for detection of Meckel's diverticulum in Tc-99m pertechnetate scintigraphy

  Tc-99m pertechnetate scintigraphy is the modality of choice for diagnosis of Meckel's diverticulum. Interpretation of Meckel's scan identifies a focal area of radiopharmaceutical uptake in the anterior abdomen similar to normal gastric mucosa. The activity must be of the same pattern and intensity as gastric uptake. We present a 13-year-old patient with gastrointestinal bleeding and anemia. Tc-99m pertechnetate scintigraphy was performed and initial images did not show any abnormal tracer activity in the abdomen. However, imaging continued and a focal activity was detected on the right side of the abdomen 60 minutes delayed image. Follow laparascope operation the Meckel's diverticulum was removed and the patient's symptoms disappeared completely. It is suggest to pay special attention to delayed images (60 minutes or beyond) especially when earlier images are negative.