Meckel's diverticulum overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
A Meckel's diverticulum, a true congenital diverticulum, is a small bulge in the small intestine present at birth. It is a vestigial remnant of the omphalomesenteric duct (also called the vitelline duct), and is the most frequent malformation of the gastrointestinal tract.
Historical Perspective
It is named after Johann Friedrich Meckel, who first described this type of diverticulum in 1809.[1][2]
Classification
Pathophysiology
Causes
Differentiating Meckel's diverticulum from Other Diseases
Epidemiology and Demographics
Meckel's diverticulum is present in approximately 2% of the population, with males more frequently experiencing symptoms.
Risk Factors
Screening
Natural History, Complications and Prognosis
Intestinal torsions around the intestinal stalk may also occur, leading to obstruction, ischemia, and necrosis.
Diagnosis
History and Symptoms
Approximately 98% of people afflicted with Meckel's diverticulum are asymptomatic. If symptoms do occur, they typically appear before the age of two.
Physical Examination
Laboratory Findings
Other Imaging Findings
A technetium-99m (99mTc) pertechnetate scan is the investigation of choice to diagnose Meckel's diverticula. This scan detects gastric mucosa; since approximately 50% of symptomatic Meckel's diverticula have ectopic gastric (stomach) cells contained within them, this is displayed as a spot on the scan distant from the stomach itself.
Other Diagnostic Studies
Tests such as colonoscopy and screenings for bleeding disorders should be performed, and angiography can assist in determining the location and severity of bleeding.
Treatment
Medical Therapy
Iron replacement to correct anemia. In major bleeding, a blood transfusion may be needed.
Surgery
Surgical treatment consists of a resection of the affected portion of the bowel.
Prevention
References
- ↑ Template:WhoNamedIt
- ↑ J. F. Meckel. Über die Divertikel am Darmkanal. Archiv für die Physiologie, Halle, 1809, 9: 421-453.