Bleeding meckel’s diverticulum: A study of the accuracy of pertechnetate scintigraphy as a diagnostic tool
| Autor: | Iain Irvine, Roisin Hayes, Ailbhe Doherty |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Pertechnetate Scintigraphy Sensitivity and Specificity 030218 nuclear medicine & medical imaging 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine medicine Humans Radiology Nuclear Medicine and imaging Child Radionuclide Imaging Retrospective Studies Sodium Pertechnetate Tc 99m medicine.diagnostic_test business.industry Infant Reproducibility of Results Retrospective cohort study General Medicine medicine.disease Endoscopy Surgery Meckel Diverticulum chemistry Child Preschool 030220 oncology & carcinogenesis Female Radiology Radiopharmaceuticals Bleeding Meckel's diverticulum Gastrointestinal Hemorrhage business Diverticulum Paediatric population |
| Zdroj: | European Journal of Radiology. 96:27-30 |
| ISSN: | 0720-048X |
| DOI: | 10.1016/j.ejrad.2017.09.008 |
| Popis: | Background The 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). Objective The 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. Method This was a retrospective study of all the Meckel scans performed over a 10 year period (2005–2015) in OLCHC, 144 in total. Results Of 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. Discussion Pertechnetate 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect