Chapter 17: GIT- Congenital Abnorm- Meckel Diverticulum

Question 1

What is A true diverticulum?

Answer 1

is a blind outpouching of the alimentary tract that is lined by mucosa, communicates with the lumen, and includes all three layers of the bowel wall.

The most common
type is the Meckel diverticulum, which occurs in the ileum.

Question 2

What is the most common
type of true diverticulum?

Answer 2

Meckel diverticulum

which occurs in the ileum

MILEUM—- sounds like Millenium

Question 3

What is the pathophysiology of Meckel diverticulum?

Answer 3

The Meckel diverticulum occurs as a result of failed involution of the vitelline duct, which
connects the lumen of the developing gut to the yolk sac.

Question 4

Describe the Meckel diverticulum.

Answer 4

This solitary diverticulum is a small
pouch extending from theantimesenteric side of the bowel ( Fig. 17-2 ).

It is a true diverticulum
with a wall that includes mucosa, submucosa, and muscularis propria.

Question 5

What is the characteristic of Meckel diverticulum?

Answer 5

• approximately 2% of the population,
• generally present within 2 feet (85 cm) of the ileocecal valve,
• are approximately 2 inches (5 cm) long,
• are twice as common in males as in females, and
• are most often symptomatic by age 2 (although only ∼4% of Meckel diverticulae are symptomatic).

These facts comprise the “rule of 2s” that is often used to help remember characteristics of Meckel diverticulae.

Mnemonic: M2M

Question 6

What is the appearance of Meckel diverticulae?

Answer 6

The mucosal lining of Meckel diverticulae may resemble
that of normal small intestine, butectopic pancreatic or gastric tissue may also be present.

The
latter may result in peptic ulceration of adjacent small intestinal mucosa and present with occult
bleeding or abdominal pain resembling acute appendicitis or intestinal obstruction.

Question 7

What is the reason for the Meckel diverticulae to have ectopic gastric tissue?

Answer 7

May result in peptic ulceration of adjacent small intestinal mucosa and present with occult
bleeding or abdominal pain resembling acute appendicitis or intestinal obstruction.

Question 8

Answer 8

FIGURE 17-2 Meckel diverticulum.

The blind pouch is located on the antimesenteric side of
the small bowel

Question 9

Less commonly, congenital diverticulae occur in other parts of the small intestine and ascending
colon

T or F

Answer 9

TRUE

Question 10

Virtually all other diverticulae are acquired and either lack muscularis entirely or have an
attenuated muscularis propria.

T or F

Answer 10

TRUE

Although acquired diverticulae may occur in the esophagus, stomach, and duodenum, the most common site is the sigmoid colon

Question 11

Although acquired diverticulae may occur in the esophagus, stomach, and duodenum, what the most common site ?

Answer 11

sigmoid colon

Question 12

Mnemonics to remember in Mecke’s Diverticulum

M2M

MiLEUM sounds like Millenium