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CT of Meckel's Diverticulitis in 11 Patients

¹ All authors: Department of Abdominal Radiology, Tisch Hospital, New York University Medical Center, 560 First Ave., New York, NY 10016.

View larger version (120K): [in a new window]   Fig. 1A. —17-year-old boy with right lower quadrant pain. CT was performed to evaluate possible acute appendicitis. CT scan obtained with oral and IV contrast material shows blind-ending tubular structure representing diverticulum (arrow) located at midline pelvis. Mild associated mesenteric inflammatory change is present.

View larger version (129K): [in a new window]   Fig. 1B. —17-year-old boy with right lower quadrant pain. CT was performed to evaluate possible acute appendicitis. CT scan obtained slightly more inferior to level in A shows diverticulum (arrow), which contains gas and particulate material. Diverticulum is surrounded by small-bowel loops that are opacified with contrast material.

View larger version (131K): [in a new window]   Fig. 1C. —17-year-old boy with right lower quadrant pain. CT was performed to evaluate possible acute appendicitis. Caudal CT scan shows reactive lymph nodes in right lower quadrant mesentery (arrow). At pathology, Meckel's diverticulitis with perforation was confirmed.

View larger version (132K): [in a new window]   Fig. 2A. —5-year-old boy with right lower quadrant pain. Initial CT scan obtained with oral contrast material and without IV contrast material shows rounded fluid-filled structure (black arrow) slightly to right of midline. Connection with umbilicus (white arrow) is shown.

View larger version (139K): [in a new window]   Fig. 2B. —5-year-old boy with right lower quadrant pain. After IV contrast material administration, delayed CT scan shows diverticular mural enhancement and lack of filling with oral contrast material (arrow). At pathology, Meckel's diverticulitis with perforation was found.

View larger version (154K): [in a new window]   Fig. 3A. —6-year-old boy with abdominal pain and vomiting for 2 days. CT scan obtained with oral and IV contrast material shows diverticulum in right lower quadrant (solid arrow), which contains mostly air. Normal appendix is visualized just lateral to diverticulum (open arrow).

View larger version (136K): [in a new window]   Fig. 3B. —6-year-old boy with abdominal pain and vomiting for 2 days. CT scan obtained slightly more inferior to level in A shows diverticulum, which contains small amount of particulate material (solid arrow). Normal air-filled appendix (open arrow) is visualized. At pathology, Meckel's diverticulitis was confirmed.

View larger version (165K): [in a new window]   Fig. 4A. —30-year-old man with right lower quadrant pain. Contrast-enhanced CT scan shows Meckel's diverticulum (straight arrow), containing air and fluid, located in right paracolic gutter anterior to ascending colon (C). Enhancing nodule (curved arrow) corresponds to ectopic pancreas. Inflammatory change in surrounding mesenteric fat is present.

View larger version (85K): [in a new window]   Fig. 4B. —30-year-old man with right lower quadrant pain. Photograph of gross pathology specimen shows Meckel's diverticulum (straight arrows) arising from adjacent ileum (i). Solid nodule corresponds to heterotopic pancreatic tissue (curved arrow), which protrudes into adjacent fat. Ruler increments are in centimeters.

View larger version (177K): [in a new window]   Fig. 5A. —54-year-old man with abdominal pain and fever. Contrast-enhanced CT scan of pelvis shows thin-walled, round, fluid- and debris-filled structure representing inflamed diverticulum (arrow). Small amount of pelvic free fluid is present.

View larger version (167K): [in a new window]   Fig. 5B. —54-year-old man with abdominal pain and fever. CT scan obtained slightly more inferior to level in A shows apparent point of attachment (straight arrow) of diverticulum (curved arrow) to small bowel (S), which is dilated and fluid-filled, consistent with obstruction. At pathology, gangrenous Meckel's diverticulum was confirmed.

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