Computed Tomography–Assisted Diagnosis of Meckel’s Diverticulum for Adults in Emergency

Abstract

Diagnosing Meckel’s diverticulum in emergency conditions remains challenging, especially in adult cases for acute abdominal complaints. Here, retrospective analysis of computed tomography (CT) findings in such conditions was performed. Retrospective analysis of fifteen adults (sixteen CT scans) with a final diagnosis of Meckel’s diverticulum who underwent a CT scan for acute abdominal complaints was performed. Nine patients received an intravenous (IV) contrast–enhanced CT scan; four of these were CT enteroclysis with oral contrast (mannitol). The accuracy of CT diagnosis was compared with pathological results. The overall accuracy of CT for diagnosing Meckel’s diverticulum is 56.2% (9/16) in our cohort. The accuracy of non-IV contrast CT and IV contrast CT is 25% (4/16) and 77.8% (7/9). All patients undergoing oral contrast (mannitol)–enhanced CT promptly received correct diagnosis. Meckel’s diverticulum localized mostly to the right quadrant, presenting with spherical/oblong morphology or blind-ended tubular aspects. Meckel’s diverticulum contained liquid and gas-like substances, and sometimes enteroliths. Inflammatory infiltrates were present in 9 cases, one with concomitant appendicitis. Obstruction was observed in 6 patients. CT is valuable for identifying Meckel’s diverticulum, especially in conjunction with contrast imaging and with good bowel preparation. An outpouching, blind-ended digestive structure from the distal small bowel is an alarm signal for Meckel’s diverticulum.