Meckel's diverticulum pathophysiology: Difference between revisions
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==Pathophysiology== | ==Pathophysiology== | ||
* During embryonic life, the vitelline duct or the omphalomesenteric duct is the connection between the midgut and the yolk sac responsible for providing nutrition to the midgut. | * During embryonic life, the [[vitelline duct]] or the [[Vitelline duct|omphalomesenteric duct]] is the connection between the [[midgut]] and the [[yolk sac]] responsible for providing [[nutrition]] to the [[midgut]]. | ||
* In the period between the fifth and the sixth weeks of gestation, the vitelline duct involutes and disappears, while the bowel is rapidly pulled into the abdominal cavity. | * In the period between the fifth and the sixth weeks of gestation, the [[vitelline duct]] involutes and disappears, while the [[Intestine|bowel]] is rapidly pulled into the [[abdominal cavity]]. | ||
* Failure of duct involution may lead to persistence of the omphalomesenteric duct with variable morphology: | * Failure of [[Duct (anatomy)|duct]] involution may lead to persistence of the [[Vitelline duct|omphalomesenteric duct]] with variable [[morphology]]: | ||
** Vitelline fistulae draining through the umbilicus | ** [[Vitelline duct|Vitelline]] [[Fistula|fistulae]] draining through the [[Navel|umbilicus]] | ||
** Vitelline cysts | ** [[Vitelline duct|Vitelline]] [[Cyst|cysts]] | ||
** Fibrous bands connecting the umbilicus to the diverticulum that may twist to cause intestinal obstruction | ** [[Fiber|Fibrous]] bands connecting the [[Navel|umbilicus]] to the [[diverticulum]] that may twist to cause [[Bowel obstruction|intestinal obstruction]] | ||
** Meckel’s diverticulum: | ** Meckel’s diverticulum: | ||
*** True diverticulum (comprising of all layers of intestinal wall i.e. mucosa, | *** True [[diverticulum]] (comprising of all layers of intestinal wall i.e. [[Mucous membrane|mucosa]], [[submucosa]] and [[Muscularis externa|muscularis propria]]) | ||
*** Arises from the antimesenteric border of the ileum , extends into the | *** Arises from the antimesenteric border of the [[ileum]], extends into the [[umbilical cord]] | ||
*** Supplied by the vitelline artery, branch of SMA, prone to torsion and subsequent ischemia, infarction and obstruction | *** Supplied by the [[Vitelline arteries|vitelline artery]], branch of the [[Superior mesenteric artery|Superior Mesenteric Artery (SMA)]], prone to torsion and subsequent [[ischemia]], [[infarction]] and [[obstruction]] | ||
*** Bears ectopic tissue due to the following reasons: | *** Bears [[Ectopic|ectopic tissue]] due to the following reasons: | ||
**** Presence of a pluripotent cell lining | **** Presence of a [[Pluripotency|pluripotent cell]] lining | ||
**** Faulty association between endodermal and neural crest cells | **** Faulty association between [[Endoderm|endodermal]] and [[Neural crest|neural crest cells]] | ||
**** Absence of inhibitory effect of the mesoderm on the local endoderm may also be responsible | **** Absence of inhibitory effect of the [[mesoderm]] on the local [[endoderm]] may also be responsible | ||
*** Types of ectopic tissue: | *** Types of [[Ectopic|ectopic tissue]]: | ||
**** Jejunal mucosa | **** [[Jejunum|Jejunal mucosa]] | ||
**** Duodenal mucosa | **** [[Duodenum|Duodenal mucosa]] or [[Duodenum|Brunner's tissue]] | ||
**** | **** [[Stomach|Gastric]] [[Mucous membrane|mucosa]] | ||
**** | **** [[Pancreas|Pancreatic]] tissue | ||
==References== | ==References== |
Revision as of 17:14, 5 January 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]
Overview
Pathophysiology
- During embryonic life, the vitelline duct or the omphalomesenteric duct is the connection between the midgut and the yolk sac responsible for providing nutrition to the midgut.
- In the period between the fifth and the sixth weeks of gestation, the vitelline duct involutes and disappears, while the bowel is rapidly pulled into the abdominal cavity.
- Failure of duct involution may lead to persistence of the omphalomesenteric duct with variable morphology:
- Vitelline fistulae draining through the umbilicus
- Vitelline cysts
- Fibrous bands connecting the umbilicus to the diverticulum that may twist to cause intestinal obstruction
- Meckel’s diverticulum:
- True diverticulum (comprising of all layers of intestinal wall i.e. mucosa, submucosa and muscularis propria)
- Arises from the antimesenteric border of the ileum, extends into the umbilical cord
- Supplied by the vitelline artery, branch of the Superior Mesenteric Artery (SMA), prone to torsion and subsequent ischemia, infarction and obstruction
- Bears ectopic tissue due to the following reasons:
- Presence of a pluripotent cell lining
- Faulty association between endodermal and neural crest cells
- Absence of inhibitory effect of the mesoderm on the local endoderm may also be responsible
- Types of ectopic tissue: