A 3-year-old boy presents with repeated episodes of painless rectal bleeding. Haemoglobin is 8 g/dL. Colonoscopy is normal. Which is the investigation of choice to establish the diagnosis?

• A Technetium-99m pertechnetate scintigraphy ✓
• B CT enterography
• C Barium follow-through study
• D Capsule endoscopy

Explanation

Painless lower gastrointestinal bleeding in a young child is the classical presentation of a Meckel's diverticulum containing ectopic gastric mucosa. Technetium-99m pertechnetate is taken up by gastric mucoidal cells, so the scintigram localises the ectopic mucosa with high sensitivity in paediatric patients. Barium studies and capsule endoscopy frequently miss the diverticulum, and CT enterography adds radiation without better detection of small heterotopic mucosal rests.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.