Meckel's Diverticulum Overview
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Questions and Answers

What is the prevalence rate of Meckel’s diverticulum in the population?

  • 1%
  • 10%
  • 2% (correct)
  • 25%

Which imaging technique is most effective for localizing Meckel’s diverticulum in patients with unexplained GI bleeding?

  • MRI
  • Ultrasound
  • 99m Tc-pertechnetate scan (correct)
  • CT scan

What are the potential complications associated with Meckel’s diverticulum?

  • Appendicitis
  • Obstruction due to adhesions
  • Ulceration of adjacent intestine (correct)
  • Diverticulitis

What is the purpose of administering glucagon in the imaging process for Meckel’s diverticulum?

<p>Relax smooth muscle and slow down peristalsis (C)</p> Signup and view all the answers

What type of mucosa typically lines a Meckel’s diverticulum?

<p>Ectopic gastric mucosa (B)</p> Signup and view all the answers

In what area of the abdomen is a Meckel’s diverticulum most commonly visualized during imaging?

<p>Right lower quadrant (B)</p> Signup and view all the answers

Which medication can be administered to enhance visualization of the diverticulum before imaging?

<p>Pentagastrin (D)</p> Signup and view all the answers

What are common adverse effects associated with glucagon administration?

<p>Nausea and vomiting (D)</p> Signup and view all the answers

What is the key effect of glucagon on the gastrointestinal tract during imaging?

<p>Relaxes smooth muscle to slow down peristalsis (A)</p> Signup and view all the answers

Which of the following is a factor that may lead to false-negative results in imaging for Meckel’s diverticulum?

<p>Removal of pertechnetate by bowel secretions (A)</p> Signup and view all the answers

What is the recommended patient preparation before imaging for Meckel’s diverticulum?

<p>Fast for at least 2 hours and avoid laxatives (D)</p> Signup and view all the answers

When visualizing Meckel’s diverticulum, how soon after Tc-pertechnetate injection is it typically seen?

<p>10-15 minutes (B)</p> Signup and view all the answers

What are the dosage recommendations for administering cimetidine for enhanced visualization?

<p>300 mg four times a day for adults (C)</p> Signup and view all the answers

Where is Meckel's diverticulum most commonly found within the abdomen?

<p>Right lower quadrant (D)</p> Signup and view all the answers

What is a potential complication arising from the gastric mucosa lining in Meckel’s diverticulum?

<p>Ulceration of the adjacent intestine (C)</p> Signup and view all the answers

Which localization techniques can enhance visualization during imaging for Meckel’s diverticulum?

<p>Additional views like obliques and postvoid images (D)</p> Signup and view all the answers

What is the primary reason for imaging to be most commonly performed in children with suspected Meckel’s diverticulum?

<p>Increased risk of intestinal obstruction (A)</p> Signup and view all the answers

What effect does hydrochloric acid and pepsin secreted by the ectopic gastric mucosa have?

<p>Causes ulceration of adjacent intestines (B)</p> Signup and view all the answers

Flashcards

What is Meckel's Diverticulum?

A small pouch or outpouching in the small intestine, usually in the lower part, that is a remnant of embryonic development.

What makes Meckel's Diverticulum special?

A condition where Meckel's diverticulum contains stomach-like tissue that produces acid, causing potential complications like ulcers.

How is Meckel's Diverticulum visualized?

An imaging technique using a radioactive tracer that concentrates in gastric mucosa, allowing visualization of Meckel's diverticulum.

What role does Glucagon play in imaging Meckel's Diverticulum?

A medication that relaxes the muscles in the intestines, slowing down the movement of food and aiding in visualizing Meckel's diverticulum.

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What are false-negative results in Meckel's Diverticulum imaging?

Incorrect test results where Meckel's Diverticulum is not identified, often due to issues like incomplete scanning or lack of active gastric mucosa.

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What are false-positive results in Meckel's Diverticulum imaging?

Incorrect test results where the scan shows a Meckel's Diverticulum but it's actually another condition, often due to similar symptoms or imaging features.

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How does a typical Meckel's Diverticulum image look?

A clear visualization of Meckel's Diverticulum containing active gastric mucosa, typically appearing 10-15 minutes after injection.

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What is a negative scan in Meckel's Diverticulum imaging?

A scan showing no evidence of Meckel's Diverticulum, used for comparison with positive scans.

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What makes Meckel's Diverticulum unique?

Meckel's Diverticulum contains tissue that's similar to the stomach lining and can produce acid, which can lead to complications.

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How do we show Meckel's Diverticulum?

Meckel's Diverticulum can be visualized using a radioactive substance that concentrates in the stomach-like tissue of the diverticulum.

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What enhances Meckel's Diverticulum visualization?

Pentagastrin or cimetidine medications are used to enhance the visualization of the diverticulum during imaging.

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How does Glucagon help with Meckel's Diverticulum imaging?

Glucagon, a medication that slows down the movement of food in the intestines, helps to keep the tracer concentrated in the diverticulum.

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What are false-negative Meckel's Diverticulum scans?

False-negative results occur when the diverticulum is missed on the scan, often because the entire abdomen wasn't scanned or the diverticulum isn't actively producing acid.

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What are false-positive Meckel's Diverticulum scans?

False-positive results occur when something else is mistaken for a Meckel's Diverticulum, like other conditions or abnormalities in the intestines.

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What does a typical Meckel's Diverticulum scan look like?

A typical Meckel's Diverticulum scan shows the diverticulum with active gastric mucosa, usually appearing about 10-15 minutes after the tracer is injected.

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What is a negative Meckel's Diverticulum scan?

A negative scan is used for comparison with positive scans and doesn't show any evidence of a Meckel's Diverticulum.

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Where is Meckel's Diverticulum typically found?

Meckel's Diverticulum is usually found in the right lower quadrant of the abdomen, but can appear anywhere in the abdominal area.

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Study Notes

Meckel's Diverticulum

  • A pouch-like outpouching of the intestine, typically in the distal ileum, a remnant of an embryonic duct.
  • Prevalence: Present in about 2% of the population, although only 25% develop symptoms.
  • Primarily diagnosed in children.
  • Imaging is most commonly performed in children.

Diverticulum Composition

  • The lining has ectopic gastric mucosa which produces hydrochloric acid and pepsin.

Potential Complications

  • Adjacent intestinal ulceration from gastric secretions.
  • Potential for gastrointestinal (GI) bleeding and lower abdominal pain.

Diagnostic Aid:

  • 99mTc-pertechnetate can precisely locate Meckel's diverticulum with unexplained GI bleeding.

Patient Preparation for Imaging

  • Fast for at least 2 hours.
  • Avoid laxatives, contrast agents, and potassium perchlorate for 3-4 days before imaging.

Drug Administration (Enhanced Visualization)

  • Pentagastrin: Subcutaneous injection (15-20 minutes prior), with a dose of 6 µg/kg.
  • Cimetidine: Oral or intravenous (1 hour prior), with doses of 300 mg four times a day for adults, 20 mg/kg/day for children, and 10-20 mg/kg/day for neonates.

Glucagon's Role

  • Relaxes smooth muscles, slows peristalsis, allowing pertechnetate to remain stationary.
  • Administered intravenously (50 mcg/kg) 10 minutes after Tc-pertechnetate injection.
  • Potential adverse effects include nausea, vomiting, and allergic reactions in susceptible individuals.

Imaging Procedure

  • Patient Positioning: Supine, centering the region between the xiphoid and pubic symphysis in the camera view.
  • Imaging Protocol: Static images every 30-60 seconds for 30-60 minutes after the tracer injection.
  • Localization Techniques: Oblique, lateral, posterior, and post-void imaging may be used for precise localization of increased activity.

Image Findings

  • Visualization: Active gastric mucosa within the diverticulum is usually visible 10-15 minutes post-injection.
  • Location: Commonly found in the right lower quadrant, but can be anywhere in the abdomen.
  • Comparison Images: Include a negative scan for comparison.

Technical Considerations

  • False-Negatives: Could be caused by missing abdominal coverage, insufficient gastric mucosa, and bowel secretion of pertechnetate.
  • False-Positives: Often from other abdominal pathologies.
  • Full Imaging Coverage: Essential to avoid false-negative results.

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Description

Explore the key aspects of Meckel's diverticulum, including its definition, prevalence, and complications. Learn about the diagnostic methods, patient preparation for imaging, and drug administration techniques to enhance visualization. This quiz is perfect for medical students and professionals seeking to deepen their understanding of gastrointestinal conditions.

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