Satomi Kawamoto MD, Presenter: Research support, Siemens AG

Siva P. Raman MD, Abstract Co-Author: Nothing to Disclose

Amanda Blackford MSc, Abstract Co-Author: Nothing to Disclose

Ralph H. Hruban, Abstract Co-Author: Royalties, Myriad Genetics, Inc

Elliot K. Fishman MD, Abstract Co-Author: Research support, Siemens AG Advisory Board, Siemens AG Research support, General Electric Company Advisory Board, General Electric Company Co-founder, HipGraphics, Inc

To determine how often complicated and uncomplicated Meckel's diverticulum is detected on CT in pediatric and adult population.

Forty (8 pediatric and 32 adult) patients (29 males and 11 females; average age: 46.2±23.7) with pathologic diagnosis of Meckel's diverticulum who had CT exam before surgical resection were evaluated. These included 26 asymptomatic adult patients with incidentally found Meckel's diverticulum during unrelated abdominal surgery, and 14 (8 pediatric and 6 adult) patients with complicated Meckel's diverticulum (4 bleeding, 6 small bowel obstruction [SBO], 2 acute diverticulitis, 1 incisional hernia, and 1 inverted Meckel's diverticulum). A total of 85 CT exams (23 CT exams for 14 patients with complicated Meckel’s diverticulum, and 62 CT exams for 26 asymptomatic patients) obtained with multiple different scanners and techniques were evaluated for detection of Meckel’s diverticulum and its complications. Technical factors for CT including IV and positive oral contrast material and subjective CT quality (excellent, good, fair, poor), and patient's factors including amount of peritoneal fat and ascites (none, minimum, moderate, large) were compared to detection of Meckel’s diverticulum using mixed-effect logistic regression models.

Meckel's diverticulum was detected in19 of 40 (47.5%) patients (average diameter: 17.1±7.7mm, length 42.6±14.7mm). Complicated Meckel's diverticulum was detected in 8 of 14 (57.1%) patients (2 bleeding, 2 SBO, 2 diverticulitis, 1 hernia, and 1 inverted Meckel's) on at least one CT exam, and 13 of 23 (56.5%) total CT exams. Uncomplicated Meckel's diverticulum was detected in 11 of 26 (42.3%) patients on at least one CT exam, and 16 of 62 (25.8%) total CT exams. Amount of peritoneal fat (p=0.02) was related to detection of Meckel's diverticulum. Amount of ascites (p=0.06) and subjective quality of axial CT (p=0.05) were not statistically significant, but tended to be related to its detection, whereas IV (p=0.59) or oral contrast (p=0.41) were unrelated to its detection.

Complicated Meckel's diverticulum was detected in 56.5% of CT exams, and uncomplicated Meckel's diverticulum was detected in 25.8% of CT exams.

Complicated Meckel’s diverticulum should be considered in patients with abdominal/gastrointestinal symptoms, and its possible CT findings should be sought. .

Kawamoto, S, Raman, S, Blackford, A, Hruban, R, Fishman, E, CT Detection of Complicated and Uncomplicated Meckel's Diverticulum.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14010861.html