Meckel diverticulum

From Libre Pathology
Revision as of 21:12, 22 March 2016 by Michael (talk | contribs) (tweak)
Jump to navigation Jump to search

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
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

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.