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March 1974

Futility of Barium Sulfate in Diagnosis of Bleeding Meckel Diverticulum

Author Affiliations

From the departments of surgery (Drs. Meguid, Canty, and Eraklis) and radiology (Drs. Wilkinson and Treves), Children's Hospital Medical Center, Harvard Medical School, Boston. Dr. Meguid is now with Peter Bent Brigham Hospital, and Dr. Canty is now with Massachusetts General Hospital, Boston.

Arch Surg. 1974;108(3):361-362. doi:10.1001/archsurg.1974.01350270091016

Thirty-two infants underwent surgery, during a 21-year period, for painless rectal bleeding due to Meckel diverticulum. Radiological examinations do not help in the diagnosis of this lesion.

Three infants had no radiological investigation before surgery. Twenty-nine infants had a barium sulfate enema, fourteen an upper gastrointestinal examination, and four had a small bowel examination. The cause of bleeding was not determined.

It is questioned whether radiological examination of the gastrointestinal tract should constitute a part of the routine investigation in a previously healthy infant who has painless rectal bleeding. The yield in making a correct diagnosis is greater from a careful history, the finding of a benign abdomen, and normal findings from sigmoidoscopic examination.

Abdominal scanning with sodium pertechnetate Tc 99m, which is selectively taken up by normal and aberrant gastric mucosa, is a helpful diagnostic tool.