Computed tomography of complicated Meckel’s diverticulum in adults: a pictorial review

Abstract

Abstract Objective To show various CT aspects of complicated Meckel’s diverticulum in adult patients to facilitate the preoperative diagnosis of this rare pathology in emergency settings. Methods A computer search of medical records over a 15 year period identified 23 adult patients who underwent surgery for acute abdomen generated by a complicated Meckel’s diverticulum. CT images available for review were analyzed, and some specific patterns leading to the diagnosis of complicated Meckel’s diverticulum are presented in this review. Results Complications were related to inflammation (14 patients), bleeding (5 patients), intestinal obstruction (3 patients), and penetrating foreign body (1 patient). The presence of a Meckel’s diverticulum was usually suggested at CT scan by an abnormal outpouching, blind-ending digestive structure connected to the terminal ileum by a neck of variable caliber. Depending on the type of complications, the diverticulum was surrounded by mesenteric inflammatory changes, or presented as a localized fluid or air-fluid collection contiguous with the terminal ileum. The diverticulum was also the source of active bleeding or acted as the lead point to intestinal obstruction or intussusception. Conclusion CT findings of complicated Meckel’s diverticulum are polymorphic and should be considered in the evaluation of adult patients with acute abdomen.