Meckel's Diverticulum—Two Cases Diagnosed Radiologically

Abstract

Any portion of the vitelline duct may fail to become obliterated; persistence of the proximal portion constitutes Meckel's diverticulum. The sacarises from the antimesenteric border of the gut and varies greatly in shape, size and position: the average distance from the ileo-caecal valve is some 50 cm (Owen and Finney, 1949). It has a complete intestinal wall and its wide ostium allows easy entrance and exit of intestinal contents. Few Meckel's diverticula give rise to trouble: symptoms when they occur are due only to complications which are themselves generally secondary to further anatomical or physiological anomalies (Edwards, 1949). Thus, for example, attachment of the sac to the abdominal wall by the remainder of the vitelline duct or the presence of heterotopic gastric or pancreatic tissue may be responsible. A number of possible complications have been reported: 1. Inflammation, perforation or strangulation of the diverticulum. 2. Obstruction or strangulation of the intestine. 3. Intussusception. 4. Tumours, cysts and calculi, all of which are rare. 5. Ulceration, usually due to secreting heterotopic gastric tissue. Especially in children, the last complication gives rise to the most common symptom of rectal haemorrhage or melaena (Grossman, Fishback and Lovelace, 1950). Lower abdominal pain may be a feature, but is not invariably present. Radiology is, of course, valuable where a Meckel's diverticulum is responsible for acute abdominal disease (Frimann-Dahl, 1951), but in practice the pre-operative radiological diagnosis is only sought where the condition is suspected because of intestinal haemorrhage.