Intestinal Duplications, Meckel Diverticulum, and Other Remnants of the Omphalomesenteric Duct

Question 1

Which is the most common congenital anomaly of the GI tract…….

Answer 1

Meckel diverticulum

Question 2

Etiology for meckel diverticulum

Answer 2

caused by the incomplete obliteration of the omphalo mesenteric duct during the 7th wk of gestation

Question 3

Incidence of M D …

Answer 3

2–3% of all infants

Question 4

A typical Meckel diverticulum …..

Answer 4

A typical Meckel diverticulum is a 3-6 cm outpouching of the ileum along the antimesenteric border 50-75 cm (approximately 2 feet) from the ileocecal valve

Question 5

Rule of 2s……

Answer 5

Meckel diverticulum are found in approximately 2% of the general population,

are usually located 2 feet proximal to the ileocecal valve and

are approximately 2 inches in length,

can contain 2 types of ectopic tissue (pancreatic or gastric),

generally present before the age of 2 yr, and

are found twice as commonly in females

Question 6

Meckel diverticulum is entrapment in an inguinal, umbilical, or femoral hernia…..

Answer 6

Littre hernia

Question 7

The majority of symptomatic Meckel diverticula are lined by an ectopic mucosa, including an acid-secreting mucosa that causes……

Answer 7

Intermittent painless rectal bleeding by ulceration of the adjacent normal ileal mucosa

Question 8

Stool in meckel diverticulitis…….

Answer 8

T he stool is typically described as brick colored or currant jelly colored

Question 9

The most common mechanism of obstruction….

Answer 9

When the diverticulum acts as the lead point of an intussusception

Question 10

Meckel diverticulum accounts for ………..% of all lower GI bleeds in children younger than 2 yr of age

Answer 10

50%

Question 11

The most sensitive study is a Meckel

Answer 11

Meckel radionuclide scan, which is performed after intravenous infusion of technetium99m pertechnetate

Question 12

Meckel scan…….

Answer 12

The mucus-secreting cells of the ectopic gastric mucosa take up pertechnetate, permitting visualization of the Meckel diverticulum

The uptake can be enhanced with various agents, including cimetidine, ranitidine, glucagon, and pentagastrin

Question 13

The treatment of a symptomatic Meckel diverticulum is…..

Answer 13

Surgical excision.

A diverticulectomy can be performed safely as either a laparoscopic or open procedure, although most continue to be performed as open procedures