Multidetector CT enteroclysis localized a Meckel's diverticulum in a case of obscure GI bleeding

Kaltenbach, Tonya; Nguyen, Chanh D. Tr.; Lau, John H.; Garland, Adella M.; Owens, Sharla K.; Shumacker, Lana; Cummings, Susan D.

doi:10.1016/j.gie.2006.01.066

Cited by 12 publications

(8 citation statements)

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“…The major reason for this limitation is that the adjacent small bowel is difficult to separate from a Meckel diverticulum [6]. With the improving spatial resolution and MPR and 3D capabilities of CT, the role of CT in the evaluation of intraabdominal conditions and diseases has increased and an increasing number of reports about the use of CT for the diagnosis of symptomatic Meckel diverticula have been published [7,11,[16][17][18][19][20][21][22][23].…”

Section: Discussionmentioning

confidence: 99%

“…There are reported cases of Meckel diverticulum causing gastrointestinal hemorrhage detected on CT, including cases with occult gastrointestinal hemorrhage using the CT enteroclysis technique [18,22], and cases of actively bleeding Meckel diverticulum with active contrast extravasation using the CT angiographic technique [17,21]. CT angiography typically detects active bleeding when the bleeding exceeds 0.3-0.5 mL/min, a rate that is slightly lower than the threshold assigned to catheter angiography (0.5 mL/min) and is higher than that of scintigraphy with 99m Tc-pertechnetate-labeled RBCs (0.1 mL/min) [25][26][27].…”

Section: Discussionmentioning

confidence: 99%

“…Low-concentration barium (Volumen [0.1% weight/volume barium with sorbitol, a nonabsorbable sugar alcohol that promotes luminal distention and limits resorption of water across the length of the small bowel]) is often used as a neutral enteric contrast material for CT enterography [16,28]. This technique has been used successfully to identify Meckel diverticulum and its complications [16,18,22]. In one of two patients with symptomatic Meckel diverticulum with hemorrhage in our study, Meckel diverticulum was detected using the CT enterography technique (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…We were unable to evaluate the ability of specific CT protocols in the detection of Meckel diverticula because of the retrospective design of this study. However, specific CT techniques related to a patient's symptoms can be useful-for example, CT angiography for actively bleeding Meckel diverticulum [17,21] and CT enterography for the detection of Meckel diverticulum with ectopic pancreatic tissue [19] or a carcinoid [16] and with occult bleeding [18,22].…”

Section: Discussionmentioning

confidence: 99%

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CT Detection of Symptomatic and Asymptomatic Meckel Diverticulum

Kawamoto

Raman

Blackford

et al. 2015

American Journal of Roentgenology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

CT Detection of Symptomatic and Asymptomatic Meckel Diverticulum

Kawamoto

Raman

Blackford

et al. 2015

American Journal of Roentgenology

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“…The traditional diagnostic test of choice for Meckel's diverticulum has been the Meckel's scan, in which technecium-99 is taken up by ectopic gastric mucosa. With the recent advent of thin slice, highly-sensitive multi-detector CT scan, the role of CT in the diagnosis of bleeding Meckel's diverticulum has emerged and will likely be examined in the years to come [4].…”

Section: Discussionmentioning

confidence: 99%

Meckel’s Diverticulum with Gastrointestinal Bleeding: Role of Computed Tomography in Diagnosis

et al. 2009

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Case Presentation and EvolutionA 26-year-old white male with a prior history of a benign cardiac arrhythmia and seasonal allergies presented with gastrointestinal bleeding and anemia. Two months prior to admission, he was seen in an urgent care clinic with intermittent, crampy left lower quadrant abdominal pain, worse 15-60 min after eating, and associated with alternating constipation and diarrhea. During that visit, a comprehensive metabolic panel, complete blood cell count and right upper quadrant ultrasound were normal. The patient was given the diagnosis of ''vigorous gastrocolic reflex'' and was successfully treated with MiralaxÒ.The patient remained in excellent health until 1 day prior to admission when he began to experience diffuse, infraumbilical, intense pain estimated to be six out of ten in severity, and an urge to defecate. While on the commode, he had an episode of transient pre-syncope. Two large, liquid maroon-colored stools and continuous bowel urgency prompted him to come to the emergency department.He denied any prior history of gastrointestinal bleeding, use of non-steroidal anti-inflammatory drugs, aspirin, alcohol or recreational drugs. He reported nausea but not vomiting and had no change in appetite or weight loss. His family history was negative for gastrointestinal malignancy. He was employed as a lawyer and had smoked one pack of cigarettes per day for 10 years.In the emergency department, his temperature was 36.2°C, pulse 67, blood pressure 97/60 mmHg, respiratory rate 20, and oxygen saturation 99% on room air. He was thin and well appearing, anicteric and slightly pale. There were no stigmata of chronic liver disease. Lungs were clear to auscultation bilaterally. Heart exhibited a regular rate and rhythm, without murmurs, rubs or gallops. His abdomen was soft, nontender and not distended; there was no organomegaly or palpable masses. Rectal examination revealed normal anal tone, no masses and liquid maroon stool.Two large bore intravenous catheters were placed, a 1-L saline bolus was given, and a nasogastric tube was placed without return of blood or bile. Laboratory tests showed white blood cell count 7,900/mm 3 , hematocrit 36.8%, platelet count 123,000/mm 3 , sodium 137 mmol/L, cloride 103 mmol/L, carbon dioxide 29 mmol/L, blood urea nitrogen 22 mg/dL, and creatinine 1.0 mg/dL. Liver function tests were normal. He was admitted to the general medical service, kept fasting with an active blood bank sample, and stool studies were sent to rule out infectious colitis. A pantoprazole drip was empirically initiated. A colonoscopy was performed the following day after bowel preparation, and blood was seen throughout the colon and terminal ileum.Twenty-four hours later, in the setting of continuous rectal bleeding, his hematocrit dropped to 24.2%. After a total of six units of packed red blood cells throughout the ensuing day, his hematocrit was 27%. In order to localize the source of bleeding, a computed tomography (CT) scan was performed using an angiography protocol. The CT revealed ac...

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