Gastroenterology: Meckel Diverticulum Flashcards
What is Meckel’s diverticulum?
A congenital diverticulum of the small intestine
What is it a remnant of?
Vitellointestinal duct
Otherwise called omphalomesenteric duct
What does it contain?
Ectopic ileal, gastric or pancreatic mucosa
What is the rule of 2s?
Occurs in 2% of population
Most present in first 2 decades of life, majority before 2 years
Is 2 feet from the ileocaecal valve
Is 2 inches long
Are most asymptomatic?
Yes
How can they present?
Abdominal pain and cramping (can mimicking appendicitis), usually RLQ
Tenderness near umbilicus
Nausea and vomiting
Rectal bleeding (severe) - classically neither bright red nor true melaena
Intestinal obstruction - secondary to volvulus, intussusception (vomiting, constipation, diarrhoea)
Diverticulitis
Is there usually an acute Hb reduction?
Yes
Is it the most common cause of painless massive GI bleeding requiring transfusion in children between 1 and 2?
Yes
What scan is useful?
A technetium scan
What will a technectium scan demonstrate?
Increased uptake by ectopic gastric mucosa (in 70% of cases)
How is it managed?
Surgical resection
What is the most common differential?
Appendicitis
What is noted on examination of abdomen?
Diffuse abdominal tenderness
May have signs of peritonitis
Is it the most common congenital abnormality of the GI tract?
Yes
Why is it a true diverticulum?
It contains all layers of the wall of the gut
What does choristoma mean?
Normal tissue at abnormal site
If gastric tissue present in the diverticulum, what will it secrete and cause?
Gastric acid (H+) leading to gastric ulcer
