Platon Alexandra, Gervaz Pascal, Becker Christoph D, Morel Philippe, Poletti Pierre-Alexandre
Insights Imaging. 2010 May;1(2):53-61. doi: 10.1007/s13244-010-0017-8. Epub 2010 Apr 14.
To show various CT aspects of complicated Meckel's diverticulum in adult patients to facilitate the preoperative diagnosis of this rare pathology in emergency settings. METHODS: A computer search of medical records over a 15 year period identified 23 adult patients who underwent surgery for acute abdomen generated by a complicated Meckel's diverticulum. CT images available for review were analyzed, and some specific patterns leading to the diagnosis of complicated Meckel's diverticulum are presented in this review. RESULTS: Complications were related to inflammation (14 patients), bleeding (5 patients), intestinal obstruction (3 patients), and penetrating foreign body (1 patient). The presence of a Meckel's diverticulum was usually suggested at CT scan by an abnormal outpouching, blind-ending digestive structure connected to the terminal ileum by a neck of variable caliber. Depending on the type of complications, the diverticulum was surrounded by mesenteric inflammatory changes, or presented as a localized fluid or air-fluid collection contiguous with the terminal ileum. The diverticulum was also the source of active bleeding or acted as the lead point to intestinal obstruction or intussusception. CONCLUSION: CT findings of complicated Meckel's diverticulum are polymorphic and should be considered in the evaluation of adult patients with acute abdomen.
展示成年患者复杂型梅克尔憩室的各种CT表现，以促进在急诊情况下对这种罕见病理情况的术前诊断。方法：通过计算机检索15年间的医疗记录，确定了23例因复杂型梅克尔憩室导致急腹症而接受手术的成年患者。对可供审查的CT图像进行分析，并在本综述中呈现一些有助于诊断复杂型梅克尔憩室的特定模式。结果：并发症与炎症（14例患者）、出血（5例患者）、肠梗阻（3例患者）和穿透性异物（1例患者）有关。在CT扫描中，梅克尔憩室的存在通常表现为异常的憩室突出，即通过可变管径的颈部与回肠末端相连的盲端消化结构。根据并发症的类型，憩室周围有肠系膜炎症改变，或表现为与回肠末端相邻的局限性液体或气液聚集。憩室也是活动性出血的来源，或作为肠梗阻或肠套叠的起始点。结论：复杂型梅克尔憩室的CT表现具有多态性，在评估成年急腹症患者时应予以考虑。
