Meckel's diverticulum is a congenital diverticulum that arises from the terminal ileum due to incomplete closure of the vitellointestinal duct during fetal development. It is the most common congenital anomaly of the small intestine. Symptomatic cases typically present with severe hemorrhage in children under 2 years old. A technetium scan is a useful diagnostic tool to detect Meckel's diverticulum, including cases with minimal bleeding. Treatment involves resection of the affected segment of ileum containing the diverticulum.
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continuation on the urinary tract disorders. congenital and acquired disorders well covered. pyelonephritis also forms part of the text. thanks for reading. remeber to like and follow
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UC is an idiopathic IBD that affects the colonic mucosa.
Hallmark of UC is bloody diarrhea often with prominent symptoms of rectal urgency and tenesmus.
The clinical course is marked by exacerbations and remissions.
The diagnosis of UC is suspected on clinical grounds and supported by the appropriate findings on
Proctosigmoidoscopy or colonoscopy
Biopsy
By negative stool examination for infectious causes
Intestinal obstruction is a significant or mechanical blockage of intestine that occurs when food or stool can not move through the intestine.
These obstruction may be complete or partial.
esophageal varices are the second most common cause of upper GI bleed after PUD.These are actually the dilated veins which occur secondary to increase in the pressure in the portal circulation called as Portal Hypertension..
continuation on the urinary tract disorders. congenital and acquired disorders well covered. pyelonephritis also forms part of the text. thanks for reading. remeber to like and follow
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The urethra's main job in males and females is to pass urine outside the body. This thin tube also has an important role in ejaculation for men. When a scar from swelling, injury or infection blocks or slows the flow of urine in this tube, it is called a urethral stricture. Some people feel pain with a urethral stricture.
MECKEL’S DIVERTICULUM
DEFINITION
It is congenital, results from incomplete closure of vitellointestinal duct..
It is the most common congenital anomaly of small intestine.
Meckel`s Diveticulum.pptx Meckel's diverticulum is the most common congenital...DrSabinShrestha1
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
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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2. • It is a congenital diverticulum arising from the
terminal ileum and is part of the unobliterated
proximal portion of the vitellointestinal duct.
3. It is:
• ™
. 2% common.
• ™
. 2 feet from the ileocaecal valve.
• ™
. 2 inch in length.
• ™
. 2% of Meckel’s diverticulum only will be
symptomatic.
• ™
. 50% of symptomatic are below 2 years of age.
• ™
. 20% heterotopic epithelium.
• ™
. 2:1 female preponderance is seen.
4. • It is congenital, results from incomplete
closure of vitellointestinal duct.
• It is the most common congenital anomaly of
small intestine.
• Arises from the antimesenteric border of the
ileum, containing all three layers of the bowel
with independent blood supply.
5. • In 20% of cases mucosa contains heterotopic
epithelium like gastric (commonest—50%),
colonic and pancreatic tissues (5%).
• It may be connected to or communicated with
the umbilicus through a band or fistula.
• It may be associated with oesophageal atresia,
exomphalos and anorectal malformations.
6. (A) Anatomy of Meckel’s
diverticulum;
(B) Meckel’s diverticulum.
7. Presentations in Meckel’s Diverticulum
• Asymptomatic—in majority cases.
• Severe haemorrhage most common, seen in children
aged 2 year or younger (Maroon-coloured blood).
• Intestinal obstruction due to bands/adhesions/
intussusception.
• Perforation.
• Intussusception, volvulus of small bowel.
• Peptic ulceration.
• Diverticulitis (20%)—features mimic acute appendicitis.
• Littre‘s hernia—it is presence of Meckel’s diverticulum
in hernial sac as content.
• It is observed in inguinal/femoral hernia
8. Diagnosis
• Technetium (Tc99) radioisotope scan is very useful (90–95%
accuracy). 90% of heterotrophic gastric mucosa can be
identified in Meckel’s diverticulum by radioisotope study. It
can detect
• Meckel’s diverticulum with minimal bleeding also (0.1 ml/
minute). So it is very useful investigation in children
presenting with bleeding.
• X-ray abdomen to see complications like obstruction,
perforation.
• Laparoscopy is very useful.
• Enteroclysis/small bowel enema under fluoroscopy may
show the
• Meckel’s diverticulum. It is probably the most accurate
investigation.
9. Treatment
• Asymptomatic Meckel’s diverticulum can be
left alone when identified during laparotomy.
• Resection of a short segment of ileum
containing Meckel’s diverticulum and end-to-
end anastomosis is done.
• Meckelian diverticulectomy with closure of
enterotomy also can be done, but chances of
retaining heterotopic tissues and stenosis are
higher.