CT findings in children with Meckel diverticulum

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.