Description

Meckel's diverticulum is a remnant of the vitellointestinal (omphlomesenteric) duct. It is present in about 2% of the population. Many patients are asymptomatic unless there is ectopic mucosa, a fibrous cord or tumor in the diverticulum.


 

Location: ileum, 80 - 100 cm from ileocecal valve (range from 15 to 167 cm)

 

Position: antimesenteric surface

 

Dimensions: 2 cm in diameter, usually 3-6 cm in length (range 1 to 26 cm)

 

Some patients will have a fibrous cord extending from the tip of the diverticulum to the umbilicus.

 

The diverticulum may be lined by:

(1) ileal mucosa

(2) gastric mucosa

(3) pancreatic tissue

(4) colonic mucosa

 

Complications:

(1) peptic ulceration with perforation

(2) diverticulitis (which may be secondary to obstruction and which may mimic acute appendicitis)

(3) acute or chronic GI bleeding

(4) intestinal obstruction from stricture

(5) volvulus

(6) intussusception

(7) leiomyoma, carcinoid tumor or other tumors

(8) drainage from the umbilicus (in infants)

 

The diverticulum can be identified with technetium-99m pertechnate if significant gastric mucosa is present. This radionuclide is taken up by gastric mucosa. Pretreatment with cimetidine will prevent secretion of the compound and intensify the image.

 


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