Podcast
Questions and Answers
What is the prevalence rate of Meckel’s diverticulum in the population?
What is the prevalence rate of Meckel’s diverticulum in the population?
Which imaging technique is most effective for localizing Meckel’s diverticulum in patients with unexplained GI bleeding?
Which imaging technique is most effective for localizing Meckel’s diverticulum in patients with unexplained GI bleeding?
What are the potential complications associated with Meckel’s diverticulum?
What are the potential complications associated with Meckel’s diverticulum?
What is the purpose of administering glucagon in the imaging process for Meckel’s diverticulum?
What is the purpose of administering glucagon in the imaging process for Meckel’s diverticulum?
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What type of mucosa typically lines a Meckel’s diverticulum?
What type of mucosa typically lines a Meckel’s diverticulum?
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In what area of the abdomen is a Meckel’s diverticulum most commonly visualized during imaging?
In what area of the abdomen is a Meckel’s diverticulum most commonly visualized during imaging?
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Which medication can be administered to enhance visualization of the diverticulum before imaging?
Which medication can be administered to enhance visualization of the diverticulum before imaging?
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What are common adverse effects associated with glucagon administration?
What are common adverse effects associated with glucagon administration?
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What is the key effect of glucagon on the gastrointestinal tract during imaging?
What is the key effect of glucagon on the gastrointestinal tract during imaging?
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Which of the following is a factor that may lead to false-negative results in imaging for Meckel’s diverticulum?
Which of the following is a factor that may lead to false-negative results in imaging for Meckel’s diverticulum?
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What is the recommended patient preparation before imaging for Meckel’s diverticulum?
What is the recommended patient preparation before imaging for Meckel’s diverticulum?
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When visualizing Meckel’s diverticulum, how soon after Tc-pertechnetate injection is it typically seen?
When visualizing Meckel’s diverticulum, how soon after Tc-pertechnetate injection is it typically seen?
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What are the dosage recommendations for administering cimetidine for enhanced visualization?
What are the dosage recommendations for administering cimetidine for enhanced visualization?
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Where is Meckel's diverticulum most commonly found within the abdomen?
Where is Meckel's diverticulum most commonly found within the abdomen?
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What is a potential complication arising from the gastric mucosa lining in Meckel’s diverticulum?
What is a potential complication arising from the gastric mucosa lining in Meckel’s diverticulum?
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Which localization techniques can enhance visualization during imaging for Meckel’s diverticulum?
Which localization techniques can enhance visualization during imaging for Meckel’s diverticulum?
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What is the primary reason for imaging to be most commonly performed in children with suspected Meckel’s diverticulum?
What is the primary reason for imaging to be most commonly performed in children with suspected Meckel’s diverticulum?
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What effect does hydrochloric acid and pepsin secreted by the ectopic gastric mucosa have?
What effect does hydrochloric acid and pepsin secreted by the ectopic gastric mucosa have?
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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.
