2. A Meckel’s diverticulum is a vestigial remnant of the
omphalomesenteric (vitellointestinal) duct
3. Meckel's diverticulum is the most prevalent congenital
anomaly of the GI tract
2% of the general population
2% prevalence, 2:1 female predominance
2 ft proximal to the ileocecal valve in adults
50% symptomatic under 2 years
Heterotropic tissue
Gastric mucosa
Pancreatic acini
Epidemiology
5. Failure or incomplete vitelline duct obliteration in wk. 8
Omphalomesenteric fistula
Enterocyst
Pathophysiology
6. Asymptomatic
Bleeding is the most common presentation in children
acid-producing from heterotopic gastric mucosa located within the
diverticulum.
Intestinal obstruction; mechanisms
1. Volvulus of the intestine around the fibrous band attaching
the diverticulum to the umbilicus
2. Entrapment of intestine by a mesodiverticular band
3. Intussusception with the diverticulum
4. Stricture secondary to chronic diverticulitis
Diverticulitis
Clinical Presentation
11. Indication for surgery
Incidentally discovered Meckel diverticulum
- Patients younger than 40 years
- Diverticula longer than 2cm
- Diverticula with narrow necks
- Diverticula with fibrous bands
- Suspected ectopic gastric tissue
- Inflamed, thickened diverticula
12. 1. Brunicardi FC, Anderson DK, Billiar TR, et al.. editors. Schwartz’s
principles of surgery. 9th ed. NewYork: Mc Graw-Hill; 2009.
2. Kuwajerwala K N. Meckel Diverticulum [Internet]. Medscape [updated
2013 Mar 7; cited 2014 Jun 25]. Available from:
http://emedicine.medscape.com
References
Editor's Notes
Soltero & Bill, 1976
lifetime risk of complications from Meckel diverticulum is 4.2%, with the risk decreasing with age