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CT findings in children with Meckel diverticulum

Doug E Olson1, Yong-Woo Kim, Lane F Donnelly

  • 1Department of Radiology, Cincinnati Children's Hospital Medical Center, MLC 5031, 3333 Burnet Ave., Cincinnati, OH 45229-3039, USA.

Pediatric Radiology
|February 4, 2009
PubMed

Insights

Computed tomography (CT) is now more frequently used to diagnose Meckel diverticulum in children presenting with abdominal pain than radionuclide scans. CT reveals three main patterns: small-bowel obstruction, intussusception, or inflammatory masses.

Area of Science:

  • Pediatric Radiology
  • Gastrointestinal Imaging
  • Surgical Pediatrics

Background:

  • Meckel diverticulum complications affect about 0.04% of the population.
  • Classic presentation involves painless rectal bleeding, typically diagnosed with radionuclide scans.
  • Increasing use of CT scans for abdominal pain in children suggests a shift in diagnostic approaches.

Purpose of the Study:

  • To review CT findings in children with pathologically confirmed Meckel diverticulum.
  • To identify characteristic CT presentation patterns for Meckel diverticulum.
  • To compare the detection rate of Meckel diverticulum by CT versus radionuclide studies.

Main Methods:

  • Retrospective review of CT scans (2004-2008) in children with diagnosed Meckel diverticulum.
  • Analysis of demographics, pathology, and specific CT features (e.g., stranding, obstruction, fluid, masses).
  • Comparison of Meckel diverticulum detection rates between CT and technetium pertechnetate studies.

Main Results:

  • 16 children (mean age 9.5 years) were identified.
  • Common CT findings included soft-tissue stranding (56%), small-bowel obstruction (56%), and free fluid (63%).
  • Three primary CT patterns emerged: small-bowel obstruction alone, intussusception with obstruction, or a cystic inflammatory mass.

Conclusions:

  • CT is now more commonly used for diagnosing Meckel diverticulum in children with abdominal pain compared to radionuclide studies.
  • CT demonstrates three main presentations: small-bowel obstruction, intussusception, or a cystic inflammatory mass.
  • CT offers a valuable alternative for evaluating suspected Meckel diverticulum in pediatric patients.
Abstract

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