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Computed tomography of complicated Meckel's diverticulum in adults
C Parra-Fariñas1, S Quiroga-Gomez1, S Castro-Boix2
1Departamento de Radiología, Hospital Universitari Vall d'Hebron, Barcelona, España.
Objective:
To review the embryology, the clinical findings and the appearance in multidetector computed tomography (MDCT) of complicated Meckel's diverticulum (DM) in adults.
Conclusion:
The presence of an MD in a MDCT should be suspected when a blind tubular structure connected to the terminal ileum by a neck of variable size is observed. Multiplanar 2D reconstructions images and CT enterography can help in the diagnosis. In patients with symptoms of obstruction or intestinal inflammation, the possibility of a complication secondary to a MD should be considered, especially when the terminal ileum and the vermiform appendix are normal. MDCT angiography, in cases of acute gastrointestinal bleeding, can identify contrast extravasation and accumulation of blood in the MD, and could demonstrate the persistent omphalomesenteric artery, which is diagnostic of MD. Other MDCT findings such as the presence of enteroliths or associated inflammatory changes around the MD can facilitate the preoperative diagnosis of MD complications.
Insights
Multidetector computed tomography (MDCT) aids in diagnosing complicated Meckel
Area of Science:
- Radiology
- Gastroenterology
- Surgical Anatomy
Background:
- Meckel's diverticulum (MD) is a congenital anomaly of the small intestine.
- Complications of MD in adults are often challenging to diagnose preoperatively.
- Multidetector computed tomography (MDCT) is a key imaging modality for abdominal pathologies.
Purpose of the Study:
- To review the embryology of Meckel's diverticulum.
- To outline the clinical presentations of complicated Meckel's diverticulum in adults.
- To describe the characteristic findings of complicated Meckel's diverticulum on MDCT.
Main Methods:
- Review of embryological development of Meckel's diverticulum.
- Analysis of clinical symptoms associated with complicated Meckel's diverticulum.
- Radiological interpretation of multidetector computed tomography (MDCT) scans.
Main Results:
- MDCT can identify a blind tubular structure connected to the terminal ileum.
- CT enterography and multiplanar reconstructions enhance diagnostic accuracy.
- MDCT angiography may reveal contrast extravasation in cases of bleeding.
Conclusions:
- Suspect Meckel's diverticulum with a blind tubular structure connected to the ileum.
- Consider MD complications in symptomatic patients with normal terminal ileum and appendix.
- MDCT findings like enteroliths and inflammation aid in preoperative diagnosis.