A 2-year-old boy has three episodes of painless bright red blood per rectum over two months. He is otherwise well with no abdominal signs. Which single investigation is most appropriate to establish the diagnosis?

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

Explanation

Painless lower gastrointestinal bleeding in a young child strongly suggests a Meckel's diverticulum containing ectopic gastric mucosa. Technetium-99m pertechnetate is taken up by gastric parietal cells, so the scan localises ectopic mucosa and is the diagnostic test of choice. Colonoscopy usually misses the diverticulum because it arises within 100 cm of the ileocaecal valve, beyond routine reach, and barium studies are insensitive.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.