Case Author(s): Marc Montella, MD and Keith Fischer, MD , 6/28/00 . Rating: #D3, #Q4

Diagnosis: Jejunal Diverticulum with Ectopic Gastric Mucosa

Brief history:

78 year old male with melena


Tc-99m RBC Study

View main image(gi) in a separate image viewer

View second image(gs). Small Bowel Follow Through

View third image(gs). Spot Image from SBFT

View fourth image(ms). Tc-99m Pertechnetate Study

Full history/Diagnosis is available below

Diagnosis: Jejunal Diverticulum with Ectopic Gastric Mucosa

Full history:

79 yo. male with myelodysplastic syndrome. He has reduced platelets and presented with lower GI bleeding.


Tc-99m in vitro labeled RBC's for the GI bleed study and Tc-99m pertechnetate for the gastric mucosa study


The GI bleed study demonstrated a small bowel source of bleeding thought to be in the left lower quadrant. NOte was made of spleenomegaly.

The gastric mucosa study performed two days later demonstrated a focus of abnormal uptake in the midline above the bladder thought to represent an area of ectopic gastric mucosa.


The jejunal diverticulum identified on the SBFT was resected and found to have ectopic gastric mucosa within it. This was thought to account for the positive gastric mucosa study. The bleeding was secondary to the effect of the gastric acid on the jejunum with ulcer formation and bleeding.

Differential Diagnosis List

Positive gastric mucosal scans can be due to Meckel's diverticula containing ectopic gastric mucosa and duplication cysts. The inflamation around intersusceptions can give false positive finding simulating positive gastric mucosa scans.

ACR Codes and Keywords:

References and General Discussion of Meckel's Scintigraphy (Anatomic field:Gasterointestinal System, Category:Neoplasm, Neoplastic-like condition)

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Case number: ms005

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