This document discusses Vitello-intestinal duct anomalies including Meckel's diverticulum. Meckel's diverticulum is the most common congenital anomaly of the small intestine, occurring in about 2% of the population. It can cause hemorrhage, intestinal obstruction, or diverticulitis. Investigations like USG, CT, and 99m Tc scans can help detect Meckel's diverticulum. Treatment involves resection of symptomatic diverticula with adjacent ileum, while asymptomatic cases may be resected or left alone.

1. Vitello-Intestine duct anomalies
NAWIN KUMAR
26-06-2014

2. Vitello-Intestinal Duct
• Syn. Omphalomesenteric duct
• Embryonic vitelline duct normaly gets
obliterated by 5th -9th week of IU life

3. Vitello intestinal duct anomalies
• Vitello-intestinal cord
• Persistent fistula
• Sinus
• Cyst
• Meckel’s diverticulum

6. Meckel’s diverticulum
• Most common congenital anomaly of small-
intestine
• In 2% population
• Rule of “2”
• Wide mouth / narrow mouth
• Pluripotent cells / ectopic epithelium

7. Clinical presentation
• Asymtomatic
• Haemorrhage – 25 to 50%
• Intestinal obstruction
• Diverticulitis

8. Haemorrhage from Meckel’s
diverticulum
• Patterns
– Acute massive haemorrhage
– Chronic bleeding, anaemia
– Recurrent self-limiting bleed
• Cause

9. Intestinal obstruction
• Volvulus
• Intussusception
• Hernia

10. • Meckel’s diverticulitis
• Neoplasms in Meckel’s diverticulum

11. Investigations for Meckel’s
diverticulum
• USG
• CT
• 99m Tc scan
– Sensitivity of 85%
– Specificity of 95%

13. Treatment
• Symptomatic Meckel’s diverticulum
– Resection with adjacent ileum
• Asymptomatic Meckel’s diverticulum
– Resection vs leaving alone