Difference between revisions of "Meckel diverticulum"
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = | | Image = Meckel%27s_Diverticulum_AFIP.jpg | ||
| Width = | | Width = | ||
| Caption = | | Caption = Gross image of a Meckel diverticulum. (AFIP/WC) | ||
| Synonyms = | | Synonyms = | ||
| Micro = small bowel mucosa, +/-gastric mucosa (foveolar epithelium, oxyntic mucosa), +/-pancreatic epithelium | | Micro = small bowel mucosa, +/-gastric mucosa (foveolar epithelium, oxyntic mucosa), +/-pancreatic epithelium | ||
| Line 13: | Line 13: | ||
| Molecular = | | Molecular = | ||
| IF = | | IF = | ||
| Gross = | | Gross = small bowel outpouching on antemesenteric aspect ~5 cm long, ~60 cm from the [[ileocecal valve]] | ||
| Grossing = | | Grossing = | ||
| Staging = | | Staging = | ||
| Line 28: | Line 28: | ||
| Prognosis = benign | | Prognosis = benign | ||
| Other = | | Other = | ||
| ClinDDx = [[acute | | ClinDDx = [[acute appendicitis]], other causes of abdominal pain | ||
| Tx = surgical removal | | Tx = surgical removal | ||
}} | }} | ||
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===Images=== | ===Images=== | ||
*[http://radiographics.rsna.org/content/24/2/565 | *[http://radiographics.rsna.org/content/24/2/565.long Pancreatic glands and gastric mucosa in a MD (radiographics.rsna.org)]. | ||
==Sign out== | |||
<pre> | |||
Small bowel with Meckel's diverticulum, Excision: | |||
- Benign small bowel diverticulum with focal active inflammation and reactive | |||
lymphoid hyperplasia at tip, compatible with clinical impression of | |||
inflamed Meckel's diverticulum. | |||
- Unremarkable small bowel wall at resection margin. | |||
</pre> | |||
==See also== | ==See also== | ||
Latest revision as of 16:23, 10 April 2023
| Meckel diverticulum | |
|---|---|
| Diagnosis in short | |
 Gross image of a Meckel diverticulum. (AFIP/WC) | |
|
| |
| LM | small bowel mucosa, +/-gastric mucosa (foveolar epithelium, oxyntic mucosa), +/-pancreatic epithelium |
| Gross | small bowel outpouching on antemesenteric aspect ~5 cm long, ~60 cm from the ileocecal valve |
| Site | small intestine |
|
| |
| Symptoms | abdominal pain |
| Prevalence | uncommon ~2% of population |
| Prognosis | benign |
| Clin. DDx | acute appendicitis, 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
Meckel diverticulum. (AFIP/WC)
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
Sign out
Small bowel with Meckel's diverticulum, Excision:
- Benign small bowel diverticulum with focal active inflammation and reactive
lymphoid hyperplasia at tip, compatible with clinical impression of
inflamed Meckel's diverticulum.
- Unremarkable small bowel wall at resection margin.