CT diagnosis of Meckel diverticulum in a paracolic internal hernia

Abstract

The autopsy incidence of internal hernia has been reported to be between 0.2% and 0.9%, and these hernias are usually diagnosed on imaging due to their complications or at surgery. Meckel diverticulum is the most common congenital anomaly of the gastrointestinal tract, occurring in 1% to 3% of the population according to autopsy studies. The condition also is usually diagnosed at surgery, by barium studies or scintigraphy, or on cross-sectional imaging due to complications. We present an unusual case of a large Meckel diverticulum in a right paracolic hernia diagnosed on multidetector computed tomography. This diagnosis was made after attacks of subacute intestinal obstruction with the aid of multiplanar reconstructions. This case emphasizes the role of multidetector computed tomography and postprocessing techniques such as multiplanar reconstruction in the diagnosis of bowel pathology.

Radiologist's perspective for the Meckel's diverticulum and its complications

“…14 With the advent of multidetector CT (MDCT), the principles and techniques of abdominal imaging underwent tremendous changes 19 and the sensitivity of diagnosing the Meckel's diverticulum has increased owing to the availability of higher spatial resolution and multiplanar isotropic reconstruction ability of the latest MDCT scanners, which allow visualization of the small bowel in various planes similar to that in barium studies. 20 Furthermore, CT enterography and enteroclysis combine the advantages of CT scanning with those of conventional barium enteroclysis studies, thus increasing their reliability in detecting the Meckel's diverticulum. 21 CT is very useful in diagnosing and assessing the complications associated with the Meckel's diverticulum, particularly intra-abdominal abscess formation, obstruction and perforation, tumours and, sometimes, in detecting active extravasation of intravenously injected contrast medium in cases with active intestinal haemorrhage.…”

Meckel’s diverticulum mesentery along with its band forming a hernial sac: A rare case of internal herniation

“…Meckel’s diverticulum (MD) is the most common congenital malformation of gastrointestinal tract [1–4] . It is the remanant of omphalomesenteric duct which is normally obliterated by 7th week of gestation.…”

An internal hernia caused by Meckel’s diverticulum: a case report

“…It is usually found in the small intestine 30 cm to 150 cm away from the ileocecal region. In most cases, Meckel's diverticulum does not cause significant gastrointestinal symptoms, however, about 4% of patients with this digestive tract malformation develop complications including gastrointestinal bleeding, diverticulitis, perforation and intestinal obstruction [3,5,6]. In some rare cases, Meckel's diverticulum may be incarcerated into the inguinal canal or femoral hernia, or other weak point of the abdominal cavity, which is also referred to as Littre hernia [7,8].…”