Meckel's diverticulum pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Pathophysiology

Presentation

Meckel's diverticulum is located in the distal ileum, usually within about 60-100 cm of the ileocecal valve. It is typically 3-5 cm long, runs antimesenterically and has its own blood supply. It's left over from the umbilical cord and intestines from our embryonic life.

A memory aid is the rule of 2's: 2% (of the population) - 2 feet (from the ileocecal valve) - 2 inches (in length) - 2% are symptomatic, there are 2 types of common ectopic tissue (gastric and pancreatic), the most common age at clinical presentation is 2, and males are 2 times as likely to be affected.

It can also be present as an indirect hernia, where it is known as a Hernia of Littre. Furthermore, it can be attached to the umbilical region by the vitelline ligament, with the possibility of vitelline cysts, or even a patent vitelline canal forming a vitelline fistula when the umbilical cord is cut. Torsions of intestine around the intestinal stalk may also occur, leading to obstruction, ischemia, and necrosis.

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