Research articleBleeding meckel's diverticulum: A study of the accuracy of pertechnetate scintigraphy as a diagnostic tool

- The reported accuracy of Meckel scans varies widely in the literature.
- More recent studies have shown improved sensitivities and specificities.
- The accuracy of Meckel scans can be as high as 100% when using modern techniques and equipment.
- A Meckel scan is of limited value when performed in cases with no rectal bleeding.

BackgroundThe reported accuracy of pertechnetate scintigraphy (Meckel scan) in investigating children with a bleeding Meckel's diverticulum has increased steadily since it was first introduced into clinical practice in 1970. Recent studies have indicated that the examination has a sensitivity of up to 94% and a specificity of up to 97% in this scenario. There have also been several misleading reviews from Departments of Surgery, suggesting that the Meckel scan has a poor predictive value, and should not be relied upon to exclude a bleeding Meckel's Diverticulum (MD).ObjectiveThe aim of this study was to assess the accuracy of pertechnetate scintigraphy performed at Our Lady's Hospital for Sick Children, Crumlin (OLCHC) on children with clinical suspicion of a bleeding MD.MethodThis was a retrospective study of all the Meckel scans performed over a 10 year period (2005-2015) in OLCHC, 144 in total.ResultsOf the total 144 scans performed, 22 were considered to be positive, and all patients were found to have a MD at surgery. 122 were negative, and in 53 of these patients, an alternative cause for symptoms was found, often at endoscopy. In the remaining 69 patients, no cause was found, despite full medical work-up. In all of these cases, symptoms resolved, and have not yet recurred, making MD very unlikely.DiscussionPertechnetate scintigraphy, when performed using meticulous technique, can provide up to 100% sensitivity CI [85.1, 100.0] and 100% specificity CI [93.2, 100.0] in diagnosing a bleeding MD in a paediatric population. This examination is seldom of value in children with no history of rectal bleeding.