Meckel's diverticulum

see also:

• diverticulitis
• emedicine

• congenital true diverticulum anomaly of the bowel due to remnant of the embryonic vitelline duct
• may contain gastric mucosa
• 4-25% develop complications with surgical lifetime risk of ~6%, mostly in the 1st 2 yrs of life
• classic quoted data:
  • rule of 2s
    • 2% of the population have the anomaly (studies suggest 0.2-4.5% of cadavers)
    • approximately 2 inches in length (avg is actually 3cm, 90% within 1-10cm, longest being 100cm!)
    • usually found within 2 feet of the ileocecal valve (avg is 34cm for those under 2yrs, 46cm for 3-21yr olds and 67cm for adults)
    • often found in children under 2 years of age
    • affects males twice as often as females (actually incidence is same in both sexes but rate of complications is 3x higher in males)

• GIT haemorrhage 20% of complications ⇒ bright PR bleeding
• small bowel obstruction 20-25% of complications
  • when incarcerated in an inguinal hernia, it is called Littré hernia
  • intussusception
• diverticulitis 10-20% of complications
• umbilical fistulae, sinuses, etc 10% of complications
• neoplasia in 4-5% of complications

• small bowel obstruction 20-50% of complications
  • usually intussusception
• diverticulitis 20% of complications
• GIT haemorrhage 12% of complications