MECKELS-DIVERTICULUM - ANGIOGRAPHIC FINDINGS IN 16 PATIENTS

OBJECTIVE. The purpose of this study was to assess the sensitivity of angiography in revealing the vitellointestinal artery or other arterio graphic abnormalities in patients in whom surgery subsequently proved Meckel's diverticulum. MATERIALS AND METHODS. From the 36 patients who had undergone a Meckel's diverticulectomy between 1980 and 1997 at Ha mmersmith Hospital or a referring hospital, we selected 18 who had und ergone preoperative angiography at our institution. Case notes and ang iograms of these 18 patients were reviewed for the presence of a persi stent vitellointestinal artery or other angiographic evidence oi a Mec kel's diverticulum. RESULTS. Angiograms of 16 of 18 patients were avai lable for review. A striking male preponderance existed (male:female = 13:3). Mean age was 28 years (range, 12-65 years). In 11 (69%) of the 16 patients, a persistent vitellointestinal artery was seen that had been noted at the time of the study and reported before surgery for ni ne patients. Other angiographic abnormalities at the site of the Mecke l's diverticulum were present in four patients and included a vascular blush, early venous return, and arterial irregularity. CONCLUSION. An giography will show a persistent vitellointestinal artery in most indi viduals with a Meckel's diverticulum who present with chronic gastroin testinal bleeding. However, the recognition of a persistent vitelloint estinal artery may be difficult because of overlying vessels, and supe rselective catheterization of distal ileal arteries may be necessary.