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Imaging Manifestations of Meckel's Diverticulum

¹ Department of Radiology, University of Michigan Health Center at Ann Arbor, Ann Arbor, MI 48100-0030.
² Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO.

View larger version (145K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1 —Image from small-bowel follow-through examination shows filling of blind-ending diverticulum (arrow) in right lower quadrant in 17-year-old girl with chronic abdominal pain.

View larger version (97K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2 —Sonogram in 30-year-old woman shows blind-ending thickened loop with gut signature correlating with inflamed Meckel's diverticulum (short arrow) in right lower quadrant. Note cecum (long arrow) and iliac vessels (arrowhead).

View larger version (109K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3 —37-year-old man with occult gastrointestinal bleeding. Axial image from CT enterography examination shows increased enhancement in Meckel's diverticulum (arrow). Surgical pathology confirmed ectopic gastric mucosa.

View larger version (133K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —17-year-old girl with abdominal pain and rectal bleeding. Selective angiograms of superior mesenteric artery show focal region of pooling surrounding Meckel's diverticulum with contrast blush (arrow).

View larger version (106K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —17-year-old girl with abdominal pain and rectal bleeding. Selective angiograms of superior mesenteric artery show focal region of pooling surrounding Meckel's diverticulum with contrast blush (arrow).

View larger version (120K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5A —26-year-old woman with Meckel's diverticulum. Technetium-99m-labeled heat-damaged RBC scans show focus of intense activity (arrows, B–D) in right lower quadrant on initial flow study. Operative findings confirmed hemorrhagic Meckel's diverticulum.

View larger version (121K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5B —26-year-old woman with Meckel's diverticulum. Technetium-99m-labeled heat-damaged RBC scans show focus of intense activity (arrows, B–D) in right lower quadrant on initial flow study. Operative findings confirmed hemorrhagic Meckel's diverticulum.

View larger version (119K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5C —26-year-old woman with Meckel's diverticulum. Technetium-99m-labeled heat-damaged RBC scans show focus of intense activity (arrows, B–D) in right lower quadrant on initial flow study. Operative findings confirmed hemorrhagic Meckel's diverticulum.

View larger version (120K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5D —26-year-old woman with Meckel's diverticulum. Technetium-99m-labeled heat-damaged RBC scans show focus of intense activity (arrows, B–D) in right lower quadrant on initial flow study. Operative findings confirmed hemorrhagic Meckel's diverticulum.

View larger version (109K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6 —26-year-old woman. Axial contrast-enhanced CT scan shows blind-ending Meckel's diverticulum with thickened mucosal folds (arrow). Pathology confirmed ectopic gastric mucosa in Meckel's diverticulum.

View larger version (93K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7A —23-year-old man. Axial contrast-enhanced CT images show blind-ending fluid-filled structure (arrow, A) resulting in small-bowel obstruction. Operative findings confirmed Meckel's diverticulum.

View larger version (84K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7B —23-year-old man. Axial contrast-enhanced CT images show blind-ending fluid-filled structure (arrow, A) resulting in small-bowel obstruction. Operative findings confirmed Meckel's diverticulum.

View larger version (124K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8A —21-year-old woman with right lower quadrant pain and neutrophilia. Axial CT scans show U-shaped loop of bowel in pelvis, suggesting volvulus of diverticulum around mesodiverticular band (arrow). Operative findings confirmed torsion of Meckel's diverticulum.

View larger version (122K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8B —21-year-old woman with right lower quadrant pain and neutrophilia. Axial CT scans show U-shaped loop of bowel in pelvis, suggesting volvulus of diverticulum around mesodiverticular band (arrow). Operative findings confirmed torsion of Meckel's diverticulum.

View larger version (67K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9A —13-year-old boy with right lower quadrant abdominal pain. CT scans reveal long-segment enteroenteric intussusception due to inverted Meckel's diverticulum (arrow, A).

View larger version (70K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9B —13-year-old boy with right lower quadrant abdominal pain. CT scans reveal long-segment enteroenteric intussusception due to inverted Meckel's diverticulum (arrow, A).

View larger version (102K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 10A —31-year-old woman. Axial CT scans show enterolith (arrow, A) in dilated infected Meckel's diverticulum. Note adjacent infiltration of ileocolic mesentery, suggesting superimposed diverticulitis (arrows, B).

View larger version (160K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 10B —31-year-old woman. Axial CT scans show enterolith (arrow, A) in dilated infected Meckel's diverticulum. Note adjacent infiltration of ileocolic mesentery, suggesting superimposed diverticulitis (arrows, B).

View larger version (133K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 11A —28-year-old woman with vomiting and abdominal pain. Axial CT scan reveals distended fluid-filled diverticulum (arrow) with narrowed neck.

View larger version (141K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 11B —28-year-old woman with vomiting and abdominal pain. CT scan shows enteroliths (arrow) in neck of diverticulum. Operative findings confirmed obstructed Meckel's diverticulum containing enterolith.

View larger version (119K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 12A —28-year-old man with 1 week of epigastric pain that subsequently localized to right lower quadrant. CT scans show inflammatory process in right lower quadrant (arrows, A) with small abscess (arrow, B and C). Operative exploration confirmed perforated Meckel's diverticulitis.

View larger version (99K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 12B —28-year-old man with 1 week of epigastric pain that subsequently localized to right lower quadrant. CT scans show inflammatory process in right lower quadrant (arrows, A) with small abscess (arrow, B and C). Operative exploration confirmed perforated Meckel's diverticulitis.

View larger version (100K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 12C —28-year-old man with 1 week of epigastric pain that subsequently localized to right lower quadrant. CT scans show inflammatory process in right lower quadrant (arrows, A) with small abscess (arrow, B and C). Operative exploration confirmed perforated Meckel's diverticulitis.

View larger version (132K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 13 —37-year-old woman with melena. Technetium-99m-labeled RBC study shows bleeding in right lower quadrant (arrow). Operative findings confirmed Meckel's diverticulum with ulcerated leiomyoma (thought to be cause of bleeding).

View larger version (103K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 14A —34-year-old man. Serial CT slices through lower abdomen show perforated Meckel's diverticulum (black arrow, B). Extraluminal gas (arrow, A), and inflammatory changes (white arrow, B) are seen adjacent to diverticulum. Operative findings confirmed imaging findings.

View larger version (107K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 14B —34-year-old man. Serial CT slices through lower abdomen show perforated Meckel's diverticulum (black arrow, B). Extraluminal gas (arrow, A), and inflammatory changes (white arrow, B) are seen adjacent to diverticulum. Operative findings confirmed imaging findings.

View larger version (105K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 14C —34-year-old man. Serial CT slices through lower abdomen show perforated Meckel's diverticulum (black arrow, B). Extraluminal gas (arrow, A), and inflammatory changes (white arrow, B) are seen adjacent to diverticulum. Operative findings confirmed imaging findings.

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