Meckel's diverticulum is the most common congenital anomaly of the small bowel. It is a remnant of the vitelline duct that normally disappears during fetal development. Meckel's diverticulum occurs in approximately 2% of the population and is located in the ileum about 2 feet from the ileocecal junction. It can contain ectopic gastric, pancreatic, or colonic mucosa. While often asymptomatic, complications can include bleeding, diverticulitis, intestinal obstruction, and intussusception. Treatment of symptomatic Meckel's diverticulum involves surgical resection of the diverticulum through open or laparoscopic surgery.

1. Meckel’s diverticulum
Dr. Dinesh. M.G
Professor of Surgery
J.J.M.M.C.
Davangere

2. Alimentary tract

3. Development of GI tract
 Foregut
 Oesophagus, Stomach, II part of duodenum
 Midgut
 Duodenum distal to ampulla of Whater
 Jejunum, Ileum, Caecum, Ascending colon
 Upto mid transverse colon
 Hindgut
 Distal transverse colon, descending & sigmoid colon,
rectum & proximal anal canal

4. Small intestine
 Duodenum
 Jejunum
 Ileum
 Microscopy
 Mucosa
 Submucosa
 Muscularis propria
 Serosa

5. Alimentary diverticula
 Occur from stomach to rectosigmoid junction
 Two types
 Congenital
 All three coats of bowel are present e.g. Meckel’s
 Acquired
 Diverticulum lacks a proper muscular coat
e.g. Traction diverticulum

6. Meckel’s diverticulum
 Most common congenital anomaly of small bowel
 It is a remnant of vitellointestinal duct
 Connects between midgut and yolksac
 Normally disappears in 7th week of intrauterine life
 Present in 2% of population
 Lies in ileum 2 feet from ileocaecal junction
 Measures 2 inches in length
 Has a separate blood supply
 May contain ectopic gastric, pancreatic or colonic mucosa

7. Vitellointestinal duct

8. Vitellointestinal duct

9. Vitellointestinal duct

10. Umbilical ‘adenoma’

11. Meckel’s diverticulum
Clinical features
 Asymptomatic
 Complications
 Severe bleeding from rectum
 Diverticulitis
 Intestinal obstruction
 Intussusception
 Volvulus
 Band compression
 Chronic peptic ulceration

12. Peptic ulceration in Meckel’s

13. Meckel’s diverticulum in infant

14. Meckel’s diverticulum
 Investigations
 Technitium (Tc99m) scan
 Barium meal follow through

15. Treatment
 Meckel’s diverticulectomy
 Open
 Laparoscopic
 Resection & anastomosis of adjacent ileum
 Management of incidental Meckel’s diverticulum
 Diverticulectomy
 In a child
 Narrow neck
 Palpable heterotopic epithelium

16. Laparoscopy

17. Meckel’s diverticulectomy

18. Points to remember
 What type of diverticulum is Meckel’s diverticulum?
 True
 Meckel’s diverticulum is a remnant of -----------
 Vitellointestinal duct
 Complications of Meckel’s diverticulum are -------
 Bleeding from rectum
 Diverticulitis
 Intestinal obstruction
 Treatment of symptomatic Meckel’s diverticulum is -----
 Meckel’s diverticulectomy

19. Thank you