Meckel’s diverticulum

During embryonic development the yolk sac attenuates and becomes intracoelomic and later develops into the mid and hind guts.

The attenuated connection between the yolk sac and the midgut is the vitelline or omphalomesenteric duct.

A finger-like projection located in the distal ileum arising from the antimesenteric border.

It is usually 40 to 60 cm from the ileocecal valve, measuring 1 to 10 cm long and 2 cm wide.

Failure of the vitelline duct the obliterate can result in the formation of a fistula, sinus tract, enteric cyst, a band between the terminal ileum and umbilicus or a Meckel’s diverticulum.

Occurs in 2% of the population.

The majority of symptomatic patients present before the age of 2 years.

Intestinal obstruction is a known complication and may be observed in as many as 40% of all symptomatic Meckel diverticula.

It is located 100 cm from the ileocecal valve and is the cause of bleeding from the small intestine in two thirds of men younger than 30 years.

Gastrointestinal bleeding results from ileal ulceration induced by acid production from heterotopic gastric mucosa often found in the diverticulum.

Meckel’s diverticulum with perforation usually occurs in early childhood.

Preoperative diagnosis is uncommon, but technetium ’99m pertechnetate scanning can make the diagnosis.

Is a true diverticulum in that all the layers of the bowel wall are present.

Most common congenital gastrointestinal abnormality.

Occurs within 2 feet of the ileocecal valve and may have different types of heterotopic mucosal cells lining it, most frequently gastric or pancreatic tissue.

60% of cases have heterotopic mucosa with 60% being gastric tissue and 19% with pancreatic mucosa.

Of bleeding diverticuli 90% have heterotopic gastric mucosa.

Typically measures 3-5 cm in length.

Can cause small bowel obstruction secondary to volvulus, ileoileal or ileocecal intussusception with the diverticulum as the lead point.

Rare cases of adenocarcinoma arising in ectopic tissue have been reported.

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