A 2-year-old boy presents with three episodes of painless rectal bleeding with maroon stools. Haemoglobin is 8 g/dL and the abdomen is soft with no tenderness. Which single investigation is most likely to establish the source of bleeding?

• A Technetium-99m pertechnetate scintigraphy ✓
• B Colonoscopy with ileal intubation
• C Video capsule endoscopy
• D Double-contrast barium enema

Explanation

Painless lower GI bleeding in a child under 2 years is classic for a Meckel diverticulum containing ectopic gastric mucosa, whose parietal cells concentrate pertechnetate, giving the Meckel scan a sensitivity above 85 percent in children. Colonoscopy frequently misses the diverticulum because it lies within 100 cm of the ileocaecal valve but is easily overlooked, and barium studies have poor yield.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.