To the Editor.— Dr Max Cooper (235: 1471, 1976) is to be complimented for using a sodium pertechnetate Tc 99m scan to correctly diagnose a case of bleeding Meckel diverticulum preoperatively. Some years ago I reviewed all of the cases of bleeding Meckel diverticulum that had been reported up to that time ( American Journal of Surgery 47:612, 1940). This study indicated that the triad of (1) a young male patient, (2) recurrent episodes of melena, and (3) mild abdominal discomfort, was just about pathognomonic for bleeding Meckel diverticulum. This observation has been confirmed repeatedly by various authors since that time. I am convinced that intricate, time-consuming, and expensive diagnostic studies are hardly justifiable in the instance of a 22-month old boy with a history of three episodes of painless melena in his lifetime and normal physical findings. Small bowel barium examinations rarely demonstrate a Meckel diverticulum. Dr Cooper, himself, reports