Meckel diverticulitis

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Recurrent right lower abdominal pain.

Patient Data

Age: 40 years
Gender: Male
ultrasound
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Info

Distended and incompressible blind-ending hypoechoic tubular structure in the right flank with prominent surrounding echogenic fat and increased vascularity on superb microvascular imaging (SMI).

ct
This study is a stack
Axial arterioportal
phase
This study is a stack
Sagittal
arterioportal phase
This study is a stack
Coronal
arterioportal phase
This study is a stack
Axial zoomed
images
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Info

Blind-ending tubular structure with thick enhanced wall communicating with small bowel with a wall-to-wall and surrounding inflammatory changes. No evidence of perforation or hemoperitoneum. No intraperitoneal free fluid.

The appendix is of retrocecal location with a normal appearance. Normal appearance of the terminal ileum well-demonstrated on zoomed images.

Case Discussion

The ultrasound and CT features of an inflamed tubular structure with normal appearance of the terminal ileum and appendix, most consistent with a Meckel diverticulitis.

Meckel diverticulitis is the inflammation of a Meckel diverticulum, which is the most common congenital structural abnormality of the gastrointestinal tract. It is considered an uncommon cause of acute abdomen and is often not correctly diagnosed pre-operatively. 

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