Learning objectives
Review the different clinical manifestations of Meckel diverticulum in children.
Describe ultrasound findings of Meckel diverticulum when complicated and not.
Background
Meckel’s diverticulum is the most common malformation of the gastrointestinal tract.
It is a remnant of the omphalomesenteric duct,
the embryological communication between the yolk sac and the developing midgut,
which obliterates by the 10th-12th week of gestation.
Incomplete obliteration of the omphalomesenteric duct may lead to a Meckel’s diverticulum,
omphalomesenteric sinus or cyst or fibrous cord.
Meckel’s diverticulum is by far the most common malformation of the omphalomesenteric duct remnants (nearly 98% of all omphalomesenteric anomalies).
It is a true diverticulum,
length up to...
Findings and procedure details
We reviewed the clinical history and imaging tests of patients with ultrasound findings suggesting complicated Meckel’s diverticulum in our tertiary pediatric hospital from 2012 to 2017.
Only those cases with surgical and pathological specimen confirmation were included in our revision.
Our pictorial review illustrates the spectrum of Meckel’s diverticulum complications and the imaging findings,
with emphasis on ultrasound.
NORMAL MECKEL DIVERTICULUM
Meckel diverticulum is a blind-ending structure that arises at the antimesenteric border of the distal ileum.
Its length and diameter are variable,
usually about...
Conclusion
Although scintigraphy is highly accurate for the diagnosis of symptomatic Meckel’s diverticulum in children,
ultrasound can be helpful in patients in whom nuclear medicine studies have been negative.
Knowledge of common and uncommon sonographic features of complicated Meckel’s diverticulum and its differential diagnosis can aid in early and appropriate diagnosis,
without the need of further radiological examinations that may imply ionizing radiation or sedation/anaesthesia.
To summarize the presence of the following US findings should make us think of a complicated Meckel’s diverticulum:
A normally appearing...
References
Kuzmich S,
Howlett DC,
Thust SC,
Radiological features of Meckel's diverticulum and its complications.
Clin Radiol 2009; 64: 109-118.
Elsayes KM,
Christine O.
Menias C.O.,
Harvin HJ.et al.
Imaging manifestations of Meckel’s Diverticulum.
AJR Am J Roentgenol 2007;189: 81-88
Matteo Baldisserotto M ,
Maffazzoni DR,
Dourado Dora M.
Sonographic Findings of Meckel's Diverticulitis in Children. AJR Am J Roentgenol 2003;180: 425-428.
Satya R,
O'Malley JP.
Meckel diverticulum with massive bleeding.
Radiology 2005; 236:836-840
Kuzmich S,
Howlett DC,
Thust SC,
Radiological features of Meckel's diverticulum and...