Meckel’s diverticulum by Dr.AmrithaAnilkumar

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MECKEL’S DIVERTICULUM DEFINITION It is congenital, results from incomplete closure of vitellointestinal duct.. It is the most common congenital anomaly of small intestine.

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MECKEL’S
DIVERTICULUM

MECKEL’S DIVERTICULUM
DEFINITION
• It is congenital,
results from
incomplete closure
of vitellointestinal
duct..
• It is the most
commoncongenital
anomaly of small
intestine.

• Arises fromthe
antimesentericborder of
the ileum, containing all
three layersof the bowel
withindependent blood
supply.
• In 20% of cases mucosa
contains heterotopic
epitheliumlikegastric
(commonest—50%),
colonicand pancreatic
tissues (5%).
CLINICALFEATURES
• It may be connectedto
or communicatedwith
theumbilicus through
a band or fistula.
• oesophageal atresia,
• Exomphalos
• anorectal
malformations
• Presentations in
Meckel’sDiverticulum
• Severe haemorrhage
(Maroon-coloured
blood).

• Intestinal obstruction
due to
bands/adhesions/
intussusception.
• Perforation.
• Intussusception
• Volvulus of small
bowel.
• Peptic ulceration.
• Diverticulitis features
mimicacute
appendicitis.
• Littre‘s hernia—it is
presence of Meckel’s
diverticulumin hernial
sac
• It is observedin
inguinal/femoral
hernia.

INVESTIGATION
• Silent Meckel’s
diverticulumfound
during
• laparotomy
• laparoscopy
• radioisotope
study.
• Carcinoid or GIST can
occur in Meckel’s
diverticulum
• Technetium(Tc99)
radioisotope scanis very
useful
• X-rayabdomento see
complications like
• Obstruction
• perforation.
• Laparoscopyis very
useful.
• Enteroclysis/small bowel
enema under fluoroscopy

TREATMENT
• AsymptomaticMeckel’s
diverticulumcan be left alone
whenidentifiedduring
laparotomy.
• Resectionof a short segment
of ileumcontaining Meckel’s
diverticulumand end-to-end
anastomosis is done.
• Meckelian diverticulectomy
with closure of enterotomy
also can be done
• But chances of retaining
heterotopictissues and
stenosis are higher.
REFERENCE
1. SRB's Manual of Surgery
by SriramBhatM
2. A Manual on Clinical
Surgeryby Das
3. A Concise textbookof
Surgeryby Das

A
Special Thanks
To A Very
Special Doctor

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ACHALASIA CARDIA (Cardiospasm) DEFINITION It is failure of relaxation of cardia (oesophago- gastric junction) due to disorganized oesophageal peristalsis, as a result of failure of integration of parasympathetic impulses causing functional obstruction (Achalasia means failure to relax—Greek). ACHALASIA CARDIA (Cardiospasm) DEFINITION It is failure of relaxation of cardia (oesophago- gastric junction) due to disorganized oesophageal peristalsis, as a result of failure of integration of parasympathetic impulses causing functional obstruction (Achalasia means failure to relax—Greek).

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MECKEL’S DIVERTICULUM- Pediatric Surgery Dear Viewers, Greetings from “Surgical Educator” Today I have uploaded a video on Meckel’s diverticulum. This is a great imitator because of its varied ways of presentation. It can present as bleeding per rectum, intestinal obstruction, pain abdomen and fecal umbilical discharge. I have discussed the epidemiology, etiology, embryology, clinical features, investigations, differential diagnosis and treatment of Meckel’s diverticulum in this video. Hope you will enjoy the video. You can watch the video in the following links: surgicaleducator.blogspot.com youtube.com/c/surgicaleducator Thank you for watching the video.

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Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract. It results from incomplete obliteration of the vitelline duct leading to the formation of a true diverticulum of the small intestine. The embryology, clinical features, diagnosis, and treatment of Meckel's diverticulum are reviewed here. The clinical evaluation of various gastrointestinal symptoms (abdominal pain, gastrointestinal bleeding, bowel obstruction) in children and adults is found in separate topic reviews. General considerations for the management of other congenital anomalies of the gastrointestinal tract are reviewed elsewhere. Meckel's diverticulum is a true diverticulum, containing all layers of the small bowel wall. It arises from the antimesenteric surface of the middle-to-distal ileum. The diverticulum represents a persistent remnant of the omphalomesenteric duct, which connects the midgut to the yolk sac in the fetus. The omphalomesenteric duct normally involutes between the fifth and sixth weeks of human gestation as the bowel settles into its permanent position within the abdominal cavity. Meckel's diverticulum is the most common congenital malformation of the gastrointestinal tract [1]. There is probably no familial predisposition for Meckel's diverticulum, although a few cases of occurrence within the same family have been reported . The prevalence of Meckel's diverticulum is increased in children born with major malfo

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