Difference between revisions of "Meckel diverticulum"
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| 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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Revision as of 21:13, 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 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
- Gastric foveolar epithelium in a MD (radiographics.rsna.org).
- Gastric glands in a MD (radiographics.rsna.org).
- Pancreatic glands in a MD (radiographics.rsna.org).