March 1983

Radiological Case of the Month

Author Affiliations

Contributed from the Department of Pediatric Radiology, The Johns Hopkins Medical Center, Baltimore.

Am J Dis Child. 1983;137(3):223-224. doi:10.1001/archpedi.1983.02140290015004

A 6½-month-old male infant had an acute onset of fever, vomiting, and constipation. There were no pertinent events in the infant's medical history.

Physical examination showed a lethargic infant in no apparent distress. The rectal temperature was 39 °C, the pulse rate was 192 beats per minute, respirations were 64/min, and the BP was 100/56 mm Hg. The abdomen was mildly distended with diffuse guarding and tenderness to palpation. A firm mass in the right upper quadrant extended to the lower quadrant. The bowel sounds were hyperactive. Leukocytosis was the only abnormal laboratory finding. Abdominal roentgenograms were obtained (Figs 1 to 3).

Denouement and Discussion  Meckel's diverticulum is a persistent remnant of the omphalomesenteric vitelline duct.1 As a mnemonic, the numeral "two" can be associated with several pertinent aspects of Meckel's diverticulum: the estimated incidence is 2%,1 most complications occur