Abstract:
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Purpose: To describe the clinical presentation and imaging findings of 26 adult patients with surgically proven Meckel's diverticula.
Methods and Materials: A search of the surgical pathology database at our institution from 1/1/1991 to 9/26/01 revealed 26 cases of surgically proven Meckel's diverticula in adult patients. The inpatient charts, imaging findings, and operative notes in each patient were retrospectively reviewed. There were 14 males and 12 females with an average age of presentation of 59 years (range: 18-86 years). All 26 patients had an abdominal radiograph, 12 had a small bowel series and 7 had a CT scan performed before surgery which were available for review. None of the patients had a nuclear medicine Meckel's scan.
Results: In all 26 patients, the clinical presentation was related to the presence of a Meckel's Diverticulum. The three most common clinical presentations were gastrointestinal bleed or anemia (n=16), small bowel obstruction (n=8) and abdominal pain of fever (n=2). Review of the pathology demonstrated that 9 patients had diverticulitis of the Meckel's diverticulum, and presented with small bowel obstruction (n=4), anemia (n=3), or fever and abdominal pain (n=2). Four of these patients had enteroliths visualized by plain radiograph or CT. One patient had carcinoid in the Meckel's diverticulum, and presented with small bowel obstruction. CT examination demonstrated a small bowel mass, and small bowel obstruction. Five patients had inverted Meckel's diverticula detected by small bowel series and presented with intermittent abdominal pain and anemia (n=3), or small bowel obstruction (n=2). One patient had an internal hernia related to the presence of a Meckel's diverticulum, and presented with small bowel obstruction. Ten patients presented with anemia and/or GI bleed and were found to have Meckels diverticula with ectopic gastric or pancreatic mucosa. The radiographs on these patients were non-specific in all. Small bowel series detected Meckel's in 6 patients.
Conclusion: The most common clinical presentation of adult patients in our series was gastrointestinal bleed and small bowel obstruction. The most common imaging finding was small bowel obstruction, enterolith and mass. The presence of these findings on imaging studies should arouse the suspicion for the uncommon diagnosis of Meckel's diverticulum in the adult population.
Questions about this event email: jpezzullo@lifespan.org
Pezzullo MD, J,
Meckel's Diverticula in the Adult: Clinical Presentations and Imaging Findings. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3108201.html
