J Korean Soc Radiol.  2010 Jan;62(1):61-65. 10.3348/jksr.2010.62.1.61.

Inverted Meckel Diverticulum in the Jejunum with CT Demonstration of Vitelline Artery and Veins: A Case Report

• Jang JY
• Kwon JH
• Kim MJ
• Rho BH
• Kang YN
• Kim OH

• KMID: 2208996
• DOI: http://doi.org/10.3348/jksr.2010.62.1.61

Abstract

Meckel diverticulum arising in the jejunum is a very rare condition, and inverted Meckel diverticulum of the jejunum has not been described previously. We report a case of inverted Meckel diverticulum of the jejunum with the computed tomography (CT) observations of the vitelline artery and veins in a 28-year-old woman. CT demonstrated an elongated intraluminal mass with a central area of fat attenuation in the jejunum as well as a vitelline artery and veins in the central area of this mass.

MeSH Terms

Adult
Arteries
Female
Humans
Jejunum
Meckel Diverticulum
Veins
Vitellins
Vitellins

Figure

• 

  Fig. 1 A 28-year-old woman with an inverted Meckel diverticulum in the distal jejunum. A. Axial contrast-enhanced abdominal CT scan in the arterial phase shows an oval ring-shaped mass within the dilated small bowel of the left mid abdomen. This mass represents the tip of an inverted Meckel diverticulum and has an alternating outer diverticular wall (white long arrow), inner mesenteric fat (long black arrow), and a central ectopic pancreatic tissue (short white arrow). A vitelline artery can be seen (short black arrow). B. Axial contrast-enhanced abdominal CT scan in the arterial phase 2 cm below (A) shows a ring-shaped mass with a single vetelline artery (long white arrow) and two vitelline veins (short black arrows). C-E. Coronal-oblique reconstruction images (C-E, from anterior to posterior) along the long axis of the inverted diverticulum show an elongated, smoothly marginated intraluminal mass parallel to the long axis of the bowel with a central area of fat attenuation surrounded by a thick collar of soft-tissue attenuation. Vitelline artery (long arrows), vitelline veins (short arrows), and ectopic pancreatic tissue (arrowheads) are well visualized. F. The gross pathologic specimen shows an elongated, longitudinal diverticular mass protruding from the pale pink to tan mucosa of distal jejunum, measuring 6.5 cm in length and 2.0 cm in diameter. The ruler indicates centimeters. G. A cut section of the diverticular mass revealed adipose tissue (asterisk) in the tip sandwiched between the continuous lining muscularis layers (short arrows). A few vitelline vessels of the diverticular root (long arrows) are running along the inner serosal wall of the diverticular mass. The ruler indicates centimeters. H. The mucosa of an inverted diverticular mass in the distal jejunum shows relatively tall slender villi and dense infiltration of inflammatory cells (H & E, ×200). I. The tip of the inverted diverticular mass shows focal erosive mucosa and underlying granulation tissue, as well as pancreatic ducts (asterisks) and acinar structures (arrows) (H & E, ×200). J. The inner serosal wall of the inverted diverticulum shows vitelline vessels (arrows) in the extramuscular dense fibroadipose tissue (H & E, ×200).

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