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

A 28-year-old woman presented with periumbilical pain and hematochezia. This patient reported intermittent periumbilical pain with a 1 year duration. Two months ago earlier, the pain became aggravated and hematochezia developed. Upon admission, the physical examination was normal. The hemoglobin level was 9.5 g/dL (normal=12-18) and the hematocrit level was 29.4% (normal=37-52). The other laboratory tests showed no abnormal findings. Upper gastrointestinal endoscopy and colonoscopy findings were normal. The contrast-enhanced CT scan showed an elongated intraluminal mass with central fat attenuation within the jejunum connected to the mesenteric fat (Figs. 1AE). The vitelline artery and veins were clearly visualized in the central fatty core ending at the tip of the inverted diverticulum (Figs. 1A-E). These vessels were separate branches that were connected to the superior mesenteric artery and vein. During surgery nine days later, a small bowel intussusception was observed and a manual reduction of the intussusception was performed. An approximately 9-cm long section of the small bowel containing the mass lesion was resected, and an end-to-end anastomosis was constructed. The segmented small intestine showed an elongated protruding mass covered with pale pink to tan mucosal tissue, measuring 6.5 cm in length and 2.0 cm J Korean Soc Radiol 2010;62:61-65