Mehl. GI. Meckel 01-02 (1)

Question 1

Definition?

Answer 1

Outpouching near the terminal ileum.

Question 2

What diverticulum?

Answer 2

True diverticulum. Contains all layers of bowel (mucosa, submucosa, muscule).

Question 3

Cause?

Answer 3

Caused by incomplete obliteration of vitelline (omphalomesenteric) duct.

Question 4

Highest Yield point????

Answer 4

it can contain heterotopic gastric or pancreatic mucosa, resulting in bleeding and blood in the stool.

Question 5

Another important point is that Meckel need not be pediatrics. This notion of rule of 2s (i.e., 2 feet from terminal ileum, 2 types of heterotopic tissue, age 2) is garbage with respect to age for USMLE.

There are Qs where it shows up in adults and students get them wrong saying, “Wait, I thought it was supposed to be kids?!” No. USMLE will happily give you a 19-year-old with Meckel.

Answer 5

.

Question 6

How is diagnosed?

Answer 6

Diagnosed with Meckel (Tc99) scan, which localizes to terminal ileum.

Question 7

Tx if asymptomatic?

Answer 7

can be left alone.

Question 8

Tx if symptomatic?

Answer 8

Only treated surgically if symptomatic with bleeding.