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Meckel's diverticulum. Internal hernia and adhesions without gastrointestinal bleeding--ultrasound and scintigraphic

H B Hawkins1, J D Slavin, R Levin

  • 1Department of Radiology, Saint Francis Hospital and Medical Center, Hartford, Connecticut, USA.

Clinical Nuclear Medicine
|December 1, 1996
PubMed

Insights

An 11-year-old boy with abdominal pain was diagnosed with a Meckel's diverticulum using ultrasound and Tc-99m pertechnetate imaging. Surgical exploration confirmed the Meckel's diverticulum and revealed a small bowel internal hernia.

Area of Science:

  • Pediatric Surgery
  • Diagnostic Imaging
  • Gastroenterology

Background:

  • Intermittent abdominal pain in children can indicate various gastrointestinal issues.
  • Meckel's diverticulum is a common congenital anomaly of the small intestine.
  • Diagnostic imaging plays a crucial role in identifying the cause of abdominal pain.

Observation:

  • Ultrasound revealed a nonperistaltic bowel loop near the umbilicus, suggesting hernia or diverticulum.
  • Technetium-99m pertechnetate scintigraphy localized a focal collection consistent with Meckel's diverticulum.
  • No signs of gastrointestinal bleeding were present.

Findings:

  • Exploratory laparotomy confirmed a Meckel's diverticulum adjacent to the terminal ileum.
  • The diverticulum was attached to the anterior abdominal wall near the umbilicus.
  • A small bowel internal hernia was identified, with bowel passing through a loop formed by the ileum and diverticulum.

Implications:

  • This case highlights the importance of considering Meckel's diverticulum in pediatric abdominal pain evaluations.
  • Combined imaging modalities can accurately diagnose Meckel's diverticulum and associated complications.
  • Prompt surgical intervention is necessary for symptomatic Meckel's diverticulum and internal hernias.

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