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   Caption        = Meckel's diverticulum |
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'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''.
{{Meckel's diverticulum}}
{{Meckel's diverticulum}}
{{CMG}}
{{CMG}} {{AE}} {{Cherry}}<br>
{{SK}}Meckel diverticulum, persistent intestinal end of vitelline duct, persistent omphalomesenteric duct, persistent vitelline duct


==[[Meckel's diverticulum overview|Overview]]==


===Natural History, Complications and Prognosis===
==[[Meckel's diverticulum historical perspective|Historical Perspective]]==
Torsions of intestine around the intestinal stalk may also occur, leading to obstruction, [[ischemia]], and [[necrosis]].


'''Meckel diverticulitis'''
==[[Meckel's diverticulum classification|Classification]]==


Meckel diverticulitis is acute inflammation of a Meckel diverticulum.
==[[Meckel's diverticulum pathophysiology|Pathophysiology]]==


* CT will demonstrate a blind-ending, tubular, round or oval structure in the right lower quadrant or periumbilical region with surrounding inflammation.
==[[Meckel's diverticulum causes|Causes]]==
* The wall of the diverticulum may show inflammatory changes such as mural thickening and contrast material enhancement.
* Soft-tissue stranding and adjacent fluid collections are also helpful features of diverticulitis.
* Occasionally an enteroliths will be present within the inflamed diverticulum.


<gallery>
==[[Meckel's diverticulum differential diagnosis|Differentiating Meckel's Diverticulum from other Diseases]]==
Image:


Meckel's-diverticulitis-001.jpg
==[[Meckel's diverticulum epidemiology and demographics|Epidemiology and Demographics]]==


Image:
==[[Meckel's diverticulum risk factors|Risk Factors]]==


Meckel's-diverticulitis-002.jpg
==[[Meckel's diverticulum screening|Screening]]==


Image:
==[[Meckel's diverticulum natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
 
Meckel's-diverticulitis-003.jpg
 
Image:
 
Meckel's-diverticulitis-004.jpg
 
</gallery>
 
==Symptoms==
Approximately 98% of people afflicted with Meckel's diverticulum are [[asymptomatic]]. If symptoms do occur, they typically appear before the age of two. 
 
The most common presenting symptom is painless [[rectal bleeding]], followed by [[intestinal obstruction]], [[volvulus]] and [[intussusception (medical disorder)|intussusception]]. Occasionally, Meckel's diverticulitis may present with all the features of [[acute appendicitis]].  Also, severe pain in the upper abdomen is experienced by the patient along with bloating of the stomach region.  At times, the symptoms are so painful such that they may cause sleepless nights with extreme pain in the abdominal area.


==Diagnosis==
==Diagnosis==
A [[technetium-99m]] (99mTc) pertechnetate scan is the investigation of choice to diagnose Meckel's diverticula. This scan detects [[gastric mucosa]]; since approximately 50% of symptomatic Meckel's diverticula have ectopic gastric ([[stomach]]) cells contained within them, this is displayed as a spot on the scan distant from the stomach itself. Patients with these misplaced gastric cells may experience peptic ulcers as a consequence. Other tests such as [[colonoscopy]] and screenings for [[bleeding disorder]]s should be performed, and [[angiography]] can assist in determining the location and severity of bleeding.
[[Meckel's diverticulum history and symptoms| History and Symptoms]] | [[Meckel's diverticulum physical examination | Physical Examination]] |  [[Meckel's diverticulum laboratory findings | Laboratory Findings]] | [[Meckel's diverticulum  x ray|X Ray]] | [[Meckel's diverticulum CT|CT]] | [[Meckel's diverticulum MRI|MRI]] | [[Meckel's diverticulum ultrasound|Ultrasound]] | [[Meckel's diverticulum other imaging findings|Other Imaging Findings]] | [[Meckel's diverticulum other diagnostic studies|Other Diagnostic Studies]]
 
'''Positive Technetium-99m pertechnetate scan'''
 
<gallery>
Image:
 
Positive-meckels-scan-001.jpg
 
</gallery>
 
===Imaging Findings===
 
* Meckel diverticulum is identified as a saccular, blind-ending structure located on the antimesenteric border of the ileum.
* Meckel diverticulum is usually found in the right lower quadrant and pelvic region.
* The junction of the diverticulum with the ileum may show a mucosal triangular plateau or triradiate fold pattern (represents the site of omphalomesenteric duct attachment to the ileum).
* Filling defects within the diverticulum may represent enteroliths, fecoliths, or foreign bodies.
* Technetium-99m pertechnetate scintigraphy is the modality of choice for evaluating pediatric patients with gastrointestinal hemorrhage and a suspected Meckel diverticulum.
* A Meckel diverticulum containing gastric mucosa will manifest as a small rounded area of increased activity in the right lower quadrant.
* Normal activity will simultaneously appear in the stomach.


==Treatment==
==Treatment==
Treatment is surgical, consisting of a [[resection]] of the affected portion of the bowel.
[[Meckel's diverticulum medical therapy|Medical Therapy]] | [[Meckel's diverticulum surgery|Surgery]] | [[Meckel's diverticulum primary prevention|Primary Prevention]] | [[Meckel's diverticulum secondary prevention|Secondary Prevention]] | [[Meckel's diverticulum cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Meckel's diverticulum future or investigational therapies|Future or Investigational Therapies]]
 
 
 
==References==
{{reflist|2}}


==Case Studies==
[[Meckel's diverticulum case study one|Case #1]]


{{Congenital malformations and deformations of digestive system}}
{{Congenital malformations and deformations of digestive system}}

Latest revision as of 15:07, 10 January 2018

Meckel's diverticulum
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Overview

Historical Perspective

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CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]
Synonyms and keywords:Meckel diverticulum, persistent intestinal end of vitelline duct, persistent omphalomesenteric duct, persistent vitelline duct

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Meckel's Diverticulum from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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