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Disseminated Islands of Gastric Mucosa in Jejunum and Ileum Detected by Technetium-99m-Pertechnetate Scintigraphy

Division of Nuclear Medicine, Departments of Pediatrics, Pediatric Surgery and Department of Pathology, University Hospital Eppendorf, Hamburg, Germany

Correspondence: For correspondence or reprints contact: Volker Heinrichs, MD, Department of Radiology, University Hospital Eppendorf, Martinstrasse, 52, 20246 Hamburg, Germany.

ABSTRACT

Disseminated islands of gastric mucosa are very rare in the small intestine. The secretion of hydrochloric acid can lead to ulceration which results in gastrointestinal bleeding. It is often difficult to localize the focus in case of gastrointestinal blood loss especially in the small bowel. Technetium-99m-pertechnetate scintigraphy may be a helpful tool in detecting ectopic gastric mucosa. We report a case of a 21-mo-old boy with recurrent gastrointestinal bleeding. By using pertechnetate scintigraphy, extensive tracer accumulation in the jejunum and proximal ileum was detected. Histologically, multiple islands of ectopic gastric mucosa were found in about 50 excited mucosal and transmural biopsies. The unusual finding of disseminated accumulation of ^99mTc-pertechnetate in the small intestine was the diagnostic clue for such a rare disease.

Key Words: ectopic gastric mucosa • tethnetium-99m-pertechnetate • gastrointestinal bleeding