INVERTED MECKEL DIVERTICULUM - CLINICAL, RADIOLOGIC, AND PATHOLOGICALFINDINGS

PURPOSE: To determine the clinical, radiologic, and pathologic finding s of inverted Meckel diverticulum by retrospectively reviewing a large series of cases. MATERIALS AND METHODS: Among 84 cases of Meckel dive rticulum, 18 (21%) were found at surgery to be inverted into the lumen of the bowel. Thirteen of these 18 (72%) cases were associated with s mall bowel intussusception and five (28%) were not. RESULTS: All 18 pa tients (median age at time of diagnosis, 32 years) were symptomatic, b ut the symptoms were subacute or chronic in 14 (78%). At barium examin ation in 15 cases, inverted diverticulum was depicted in 10 (67%) as a solitary, elongated, smoothly marginated, often club-shaped intralumi nal mass in the distal. ileum. At computed tomography (CT) in three ca ses, a central area of fat attenuation was surrounded by a thick colla r of soft-tissue attenuation. At ultrasound (US) in two cases, a targe tlike mass contained a central area of increased echogenicity. At path ologic examination in all cases, the inverted sac contained mesenteric fat. CONCLUSION: Inverted Meckel diverticulum occurs more commonly th an previously recognized and is associated with characteristic finding s at barium examination, CT, and US.