Case 15
History:
25 year old male with acute right lower quadrant pain
Findings:
CT of the abdomen showing a tubular structure arising from the distal ileum with adjacent inflammation.
Diagnosis:
Perforated Meckel’s diverticulum
Discussion:
Meckel’s diverticulum is a congenital sacculation of the distal ileum occurring in 2 to 3 percent of people. It is usually located within 100 cm of the ileocecal valve and often contains heterotopic gastric tissue, pancreatic tissue, or both. Only about 2 percent of people with Meckel’s diverticulum develop complications. Although diverticula are equally common among males and females, males are 2 to 3 times more likely to have complications such as bleeding, perforation and obstruction. Tc-99m pertechnetate scintigraphy has an overall specificity and sensitivity of 90 percent for establishing the diagnosis.
References:
- Mettler F, Milton J. Essentials of nuclear medicine imaging. 3rd ed. Philadelphia: WB Saunders, 1991: 195-196.
- Eisenberg R. Gastrointestinal radiology: a pattern approach. 2nd ed. Philadelphia: JB Lippincott, 1990:536-538.
