Difference between revisions of "Meckel diverticulum"

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      =
| Width      =
| Caption    =
| Synonyms  =
| Micro      = small bowel mucosa, +/-gastric mucosa (foveolar epithelium, oxyntic mucosa), +/-pancreatic epithelium
| Subtypes  =
| LMDDx      =
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Staging    =
| Site      = [[small intestine]]
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  = abdominal pain
| Prevalence = uncommon ~2% of population
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    = [[acute appendicits]], other causes of abdominal pain
| Tx        = surgical removal
}}
'''Meckel diverticulum''' (also '''Meckel's diverticulum'''), is congenital structure of the distal [[small bowel]] that occasionally gets inflamed and may present with [[acute appendicitis]]-like symptoms.
'''Meckel diverticulum''' (also '''Meckel's diverticulum'''), is congenital structure of the distal [[small bowel]] that occasionally gets inflamed and may present with [[acute appendicitis]]-like symptoms.



Revision as of 21:12, 22 March 2016

Meckel diverticulum
Diagnosis in short

LM small bowel mucosa, +/-gastric mucosa (foveolar epithelium, oxyntic mucosa), +/-pancreatic epithelium
Site small intestine

Symptoms abdominal pain
Prevalence uncommon ~2% of population
Prognosis benign
Clin. DDx acute appendicits, other causes of abdominal pain
Treatment surgical removal

Meckel diverticulum (also Meckel's diverticulum), is congenital structure of the distal small bowel that occasionally gets inflamed and may present with acute appendicitis-like symptoms.

General

  • Most common congenital anomaly of the gastrointestinal tract.[1]
    • Remnant of the omphalomesenteric duct - a connection of the yolk sac and midgut.

The rule of 2s:

  • 2 feet from the terminal ileum
  • 2% of the population
  • 2% symptomatic.
  • 2 inches long.
  • 2 year old.
  • 2 types of epithelium - gastric and pancreatic.

Main clinical DDx of a symptomatic Meckel diverticulum:

Gross

  • Antimesenteric attachement, i.e. a Meckel's diverticulum hangs off the side opposite of the mesentery.

Image

Microscopic

Features:[1]

  • Small bowel mucosa.
  • +/-Gastric mucosa:
    • Foveolar epithelium: champagne flute-like columnar epithelium.
    • Oxyntic mucosa: parietal cells (pink) and chief cells (purple).
  • +/-Pancreatic epithelium:
    • Pancreatic acini.

Images

See also

References

  1. 1.0 1.1 Levy, AD.; Hobbs, CM.. "From the archives of the AFIP. Meckel diverticulum: radiologic features with pathologic Correlation.". Radiographics 24 (2): 565-87. doi:10.1148/rg.242035187. PMID 15026601.