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Barium Studies in Meckel Diverticulum-Reply
PETER E. GIUSTRA, MD
Rockland, Me
AMA Arch Surg. 1974;109(1):123.
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To the Editor.—As a radiologist, I agree that the demonstration of a Meckel diverticulum by the use of barium sulfate can be difficult. I totally disagree with the manner in which Dr. Meguid et al (Arch Surg 108:361, 1974) came to this conclusion. Simply stated, if barium did not fill the terminal segment of ileum where the Meckel diverticulum is usually found, then the radiographic study is incomplete and no conclusion can be drawn. In the series of Dr. Meguid et al, 29 infants had barium sulfate enemas. Did all reflux into an adequately filled terminal ileum? Fourteen patients had an upper gastrointestinal exam, and I must assume that in none did barium reach the terminal ileum. Only four patients had a small bowel examination, and there is no mention of a 24-hour delay x-ray film. From the information in this article, then, I can only assume that four
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