Meckel's diverticulum

Meckel's diverticulum
Meckel's diverticulum

For patient information click here.

Meckel's diverticulum Microchapters
Home
Patient Information
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
Diagnostic Study of Choice
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
Meckel's diverticulum On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Meckel's diverticulum All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Meckel's diverticulum
CDC on Meckel's diverticulum
Meckel's diverticulum in the news
Blogs on Meckel's diverticulum
Directions to Hospitals Treating Meckel's diverticulum
Risk calculators and risk factors for Meckel's diverticulum

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Natural History, Complications and Prognosis

Torsions of intestine around the intestinal stalk may also occur, leading to obstruction, ischemia, and necrosis.

Meckel diverticulitis

Meckel diverticulitis is acute inflammation of a Meckel diverticulum.

• CT will demonstrate a blind-ending, tubular, round or oval structure in the right lower quadrant or periumbilical region with surrounding inflammation.
• 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.

• 
• 
• 
• 

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 disorders should be performed, and angiography can assist in determining the location and severity of bleeding.

Positive Technetium-99m pertechnetate scan

• 

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 is surgical, consisting of a resection of the affected portion of the bowel.

References

Template:Congenital malformations and deformations of digestive system de:Meckel-Divertikel it:Diverticolo di Meckel

Template:WikiDoc Sources