Melissa T. Myers

The appearance of inverted Meckel diverticulum with intussusception on air enema

Abstract This paper presents the appearances of inverted Meckel diverticulum with an irreducible intussusception on air enema in four children. The inverted Meckel diverticulum appeared as a bulbous (3) or triangular (1) filling defect in the air column projecting off the distal end of the soft tissue mass of the irreducible intussusceptum. The bulbous defect appears to be highly suggestive, and may be specific, for inverted Meckel diverticulum. Earlier recognition of the presence of the Meckel diverticulum as the lead point of the intussusception could have changed the management in two of the children.

Unenhanced helical CT in the evaluation of the urinary tract in children and young adults following urinary tract reconstruction : comparison with sonography

Purpose. To compare the accuracy of unenhanced, helical CT with sonography for the detection of complications of urinary tract reconstruction. Materials and methods. Forty-six kidneys in 24 patients were examined with CT and sonography. All scans were assessed for ease of renal visualization, presence of renal, ureteral, and bladder calculi, renal scars, hydronephrosis, and abdominal wall hernia. The results of both imaging modalities were independently reported. Results. CT provided excellent visualization of all 46 kidneys, while sonography provided poor visualization of 8 kidneys (17 %) (P < 0.001). CT detected calculi in 10 kidneys, 1 ureter, and 7 bladders. Sonography detected calculi in only 2 kidneys, and 2 bladders. Overall, CT detected significantly more calculi than US (18 vs 4, P = 0.01). CT detected scarring in 15 kidneys, while sonography detected scarring in 10. Hydronephrosis was detected in 6 kidneys by CT and in 8 kidneys by sonography. Three abdominal wall hernias were seen at CT that were not seen at sonography. Conclusion. CT is superior to sonography for the detection of urinary tract calculi and renal scarring. CT will demonstrate abdominal wall hernias that are unsuspected.

Segmental omental infarction in a 9-year-old girl

Omental infarction is an unusual cause of acute abdominal pain in children. The clinical presentation may mimic cholecystitis or appendicitis, but crosssectional imaging by ultrasound or computed tomography will demonstrate characteristic findings in a location corresponding to the patients point of maximal tenderness. These findings consist of an ovoid mass in the omental fat with surrounding inflammatory changes.