Paediatric GI surgery: Meckel diverticulum: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Paediatric GI surgery: Meckel diverticulum

Sample item

A 3-year-old boy passes a large volume of painless maroon stool. He is pale, but the abdomen is soft and haemodynamically he is stable. Endoscopy of the upper and lower gut is normal. Which investigation is most useful?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Technetium-99m pertechnetate scan

Painless rectal bleeding in a toddler suggests a Meckel diverticulum, a remnant of the vitelline duct about 2 feet from the ileocaecal valve in roughly 2% of people. Bleeding comes from peptic ulceration of adjacent ileum caused by acid from ectopic gastric mucosa. Technetium-99m pertechnetate is taken up by gastric mucosa and highlights the diverticulum.

Option by option

  • A. Ultrasound of the abdomen for intussusception

    Ultrasound is used for intussusception, which presents with colicky pain and redcurrant jelly stool.

  • B. Technetium-99m pertechnetate scan (correct)

    Pertechnetate is taken up by ectopic gastric mucosa, which makes the diverticulum visible.

  • C. Barium meal follow-through

    Contrast follow-through has a low yield for Meckel diverticulum.

  • D. Plain abdominal radiograph

    A plain film is non-specific and does not show the bleeding source.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Technetium-99m pertechnetate scan. Painless rectal bleeding in a toddler suggests a Meckel diverticulum, a remnant of the vitelline duct about 2 feet from the ileocaecal valve in roughly 2% of people.

Why is "Ultrasound of the abdomen for intussusception" not the answer?

Ultrasound is used for intussusception, which presents with colicky pain and redcurrant jelly stool.

Why is "Barium meal follow-through" not the answer?

Contrast follow-through has a low yield for Meckel diverticulum.

Why is "Plain abdominal radiograph" not the answer?

A plain film is non-specific and does not show the bleeding source.

What concept does this question test?

It tests Paediatric GI surgery: Meckel diverticulum in General Surgery. Bleeding comes from peptic ulceration of adjacent ileum caused by acid from ectopic gastric mucosa. Technetium-99m pertechnetate is taken up by gastric mucosa and highlights the diverticulum.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric GI surgery: Meckel diverticulum?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.