Learning objectives
The purpose of our educational exhibit is to:
- Understand the pathophysiology and prevalence of complicated Meckel’s diverticulum.
-Enumarate the possible complications of Meckel’s diverticulum and common imaging findings in this case.
Background
Meckel’s diverticulum is a remnant of the vitelline duct (omphalomesenteric duct),
which is usually located on the antimesenteric border of the ileum
Pathology/ Embryology /anatomy
General features
Partial or complete failure of involution of the omphalomesenteric duct results in a variety of anomalies,
including Meckel diverticulum.It is the most common omphalomesenteric duct anomaly and the most prevalent congenital malformation of the small bowel.
Gross pathologic features
Meckel diverticulum often is described according to the so-called rule of 2s: It is seen in approximately 2% (range,...
Findings and procedure details
Clinical presentation
Meckel’s diverticulum is usually asymptomatic.
Clinical symptoms arise from complications of the diverticulum in 2-4 % of patients such as:
Gastrointestinal bleeding:(Fig.1)
Gastrointestinal bleeding is common among adults and is caused by peptic ulcers of the diverticulum in the presence of heterotopic gastric mucosa.
Inflammation: diverticulitis/perforation/abcess(Fig.2-3)
Diverticulitis is a result of ulceration secondary to acid secretion from ectopic gastric mucosa.
In addition,
obstruction of a diverticulum by an enterolith and foreign body impaction also may lead to inflammation(Fig.4),
necrosis,
and eventual perforation.
small...
Conclusion
Being a difficult diagnosis,
the Knowledge of the radiologic characteristics of Meckel’s diverticulum will aid in the early and accurate diagnosis of cases with complications.
References
1-Cullen JJ,Kelly KA,Moir CR,Hodge DO,Zinsmeister AR,Melton LJ 3rd.Surgical management of Meckel’s diverticulum: an epidemiologic,
population-based study
2-Levy AD,Hobbs CM.From the archives of the AFIP.
Meckel diverticulum: radiologic features with pathologic correlation.
3-Levy AD,Hobbs CM.Meckel diverticulum: radiologic features with pathologic correlation.RadioGraphics2004;24(2):565–587
4-Dumper J,Mackenzie S,Mitchell P,Sutherland F,Quan ML,Mew D.Complications of Meckel's diverticula in adults.Can J Surg2006;49(5):353–357.
5-Elsayes KM,Menias CO,Harvin HJ,Francis IR.Imaging manifestations of Meckel's diverticulum.AJR Am J Roentgenol2007;189(1):81–88.
6-Thurley PD,Halliday KE,Somers JM,Al-Daraji WI,Ilyas M,Broderick NJ.Radiological features of Meckel's diverticulum and its complications.Clin Radiol2009;64(2):109–118.