CT Detection of Symptomatic and Asymptomatic Meckel Diverticulum

OBJECTIVE: The objective of our study was to determine how often symptomatic Meckel diverticulum and asymptomatic Meckel diverticulum are detected on CT in patients with known Meckel diverticulum and to evaluate factors that influence detection. MATERIALS AND METHODS: A total of 85 CT examinations of 40 patients (eight pediatric patients and 32 adult patients; 29 male patients and 11 female patients; average age, 46.2 ± 23.7 [SD] years) with a pathologic diagnosis of Meckel diverticulum were retrospectively evaluated. These patients included 26 adult patients with incidentally found asymptomatic Meckel diverticulum and 14 patients (eight pediatric and six adult patients) with symptomatic Meckel diverticulum. The CT technical factors and patients' morphologic factors were compared with the detection of Meckel diverticulum using mixed-effect logistic regression models. RESULTS: Meckel diverticulum was detected on at least one CT examination in eight of 14 (57.1%) symptomatic patients (two of four patients with bleeding, two of six patients with small-bowel obstruction, two of two patients with acute diverticulitis, one of one patient with incisional hernia, and one of one patient with inverted Meckel diverticulum) and in 13 of 23 (56.5%) total CT examinations. Asymptomatic Meckel diverticulum was detected on at least one CT examination in 11 of 26 (42.3%) patients and in 16 of 62 (25.8%) total CT examinations. The amount of peritoneal fat was related to the detection of Meckel diverticula (p = 0.02). Although not statistically significant, the subjective quality of axial CT (p = 0.05) tended to be related to detection, whereas the use of IV (p = 0.59) or positive oral (p = 0.41) contrast material was unrelated to detection. In the original CT reports, none of the asymptomatic cases of Meckel diverticulum was prospectively detected, whereas Meckel diverticulum was detected or mentioned as a possibility in 64% of the symptomatic cases. CONCLUSION: In patients with known Meckel diverticulum, CT can detect Meckel diverticulum in up to 47.5% of all patients. Meckel diverticulum is more commonly detected in symptomatic patients than in asymptomatic patients, and detection is related to the amount of peritoneal fat.