Meckel diverticulum

  • Failure of yolk sac to close in fetal life
  • 0.5-3% of population
  • Seen on anti mesenteric border of ileum
  • 30-90 cm from ileocecal valve
  • Size from 0.5 to 13 cm
  • 20-40% cases symptomatic
  • Complications: ulceration, bleeding, perforation, inflammation, intussusception, internal hernia, volvulus, adhesions
  • Ectopic gastric mucosa in 20% of adults and all children who present with bleeding 
  • Pre-op diagnosis difficult
  • Tc 99m radionuclide imaging more accurate in children
  • Enteroclysis: blind-ending sac from anti-mesenteric border of ileum, triradiate mucosal folds seen at base of diverticulum. Diverticulum if inverted, appears like a polypoid filling defect, and can present with intussusception
  • CT: role in inflamed diverticulum. Thick homogeneously enhancing walls, adjacent inflammation. Sometimes endolith is seen. 
  • Angiography: persistent vitelline artery is hallmark in patients with chronic GI bleed
Read more

Levy, Angela D., and Christine M. Hobbs. “From the archives of the AFIP: Meckel diverticulum: radiologic features with pathologic correlation.” Radiographics 24.2 (2004): 565-587.

Satya, Ramadas, and Janis P. O’Malley. “Case 86: Meckel diverticulum with massive bleeding.” Radiology 236.3 (2005): 836-840.