Ch. 331.2 - Meckel Diverticulum

Question 1

MC congenital anomaly of the GI tract

Answer 1

Meckel diverticulum

Question 2

Meckel diverticulum is caused by

Answer 2

Incomplete obliteration of the omphalomesenteric duct during the 7th week of gestation

Question 3

Location of Meckel diverticulum

Answer 3

3-6 cm out pouching of the ileum along the anti mesenteric border 50-75 cm from the ileocecal valve

Question 4

Rule of 2s referring to classic presentation of Meckel diverticulum (6)

Answer 4

1) ~2% of the general population 2) 2 feet proximal to the ileocecal valve 3) ~2 inches in length 4) 2 types of ectopic tissue 5) Before the age of 2yrs 6) 2x more common in females

Question 5

Entrapment of Meckel diverticulum in a femoral hernia

Answer 5

Littre hernia

Question 6

Meckel diverticulum is a remnant of what structure

Answer 6

Omphalomesenteric duct

Question 7

Omphalomesenteric duct usually obliterates when

Answer 7

Between 5th and 7th wk of gestation

Question 8

Symptoms of Meckel diverticulum usually arise when

Answer 8

1st or 2nd year of life

Question 9

Ectopic mucosa of Meckel diverticulum us most commonly of ___ origin

Answer 9

Gastric

Question 10

Stool description as an outcome of painless rectal bleeding from Meckel diverticulum

Answer 10

Brick-colored or currant jelly

Question 11

Bleeding from Meckel diverticulum can cause significant anemia but is usually self-limited because of

Answer 11

Contraction of the splanchnic vessels as the patients become hypovolemic

Question 12

MC mechanism of obstruction associated with Meckel diverticulum

Answer 12

Diverticulum acts as lead point of an intussusception

Question 13

T/F Mean age of onset of obstruction associated with Meckel diverticulum is younger than that for patients presenting with bleeding

Answer 13

T

Question 14

Mean age of Meckel diverticulum presenting as diverticulitis mimicking acute appendicitis

Answer 14

8 y/o

Question 15

Meckel diverticulum accounts for ___% of all LGIB in children younger than 2

Answer 15

50

Question 16

Most sensitive study to diagnose a Meckel diverticulum

Answer 16

Meckel radionuclide scan using technetium-99m pertechnetate

Question 17

Uptake of technetium-99m pertechnetate by ectopic gastric mucosa of Meckel diverticulum can be enhanced by

Answer 17

Cimetidine, ranitidine, glucagon, pentagastrin

Question 18

Sensitivity and specificity of enhanced Meckel scan

Answer 18

85% and 95%

Question 19

False-negative scan may be seen in what condition

Answer 19

Anemia

Question 20

Method of detection of Meckel diverticulum that is best done when the patient is actively bleeding

Answer 20

Radiolabeled tagged RBC scan

Question 21

Treatment of a symptomatic Meckel diverticulum

Answer 21

Surgical excision/diverticulectomy

Question 22

Risk of serious complication from Meckel diverticulum seem to exceed operative risk in children of what age group

Answer 22

Younger than 8 years old