Meckel diverticulum pathologies in pediatric patients; case-based approach

Akış S., Sarıoğlu F. C.

Balkan Radiology Congress 2024, İzmir, Türkiye, 23 - 26 Ekim 2024, (Özet Bildiri)

  • Yayın Türü: Bildiri / Özet Bildiri
  • Basıldığı Şehir: İzmir
  • Basıldığı Ülke: Türkiye
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

INTRODUCTION

Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract. Even if it is generally asymptomatic it can lead to significant clinical complications such as gastrointestinal bleeding and diverticulitis. This abstract presents two distinct cases that illustrate the diverse presentations and imaging findings associated with Meckel's diverticulum.

CASES

In the first case, a pediatric patient presented with gastrointestinal bleeding. Initial imaging using technetium-99m pertechnetate scintigraphy was performed; however, the results were negative due to the presence of ectopic pancreatic tissue within the diverticulum, which complicated the diagnosis. CT findings included a tubular structure arising from the antimesenteric border of the ileum, with associated inflammatory changes indicative of bleeding. The second case involved a pediatric patient who experienced perforation of a Meckel's diverticulum. CT findings included a blind-ending, tubular structure arising from the ileum, with surrounding inflammatory changes and free air, consistent with perforation.

DISCUSSION

These cases emphasize the critical role of imaging techniques in the diagnosis and management of Meckel's diverticulum and its complications. Ectopic pancreatic tissue is the second most common ectopic tissue found in Meckel's diverticula after gastric mucosa. In cases where the ectopic tissue is pancreatic rather than gastric, the Meckel scan may be negative, as pancreatic tissue does not concentrate the radiotracer. This case highlights the importance of considering atypical presentations and the limitations of scintigraphy when ectopic pancreatic tissue is involved.Also one should consider Meckel's diverticulum in the differential diagnosis of acute abdominal pain, especially when complicated by diverticulitis or perforation.

CONCLUSION

Radiologists should maintain a high index of suspicion for this condition, as early recognition can significantly improve patient outcomes.