Dr. Ertan Beyatlı

What is Meckel's Diverticulum?

(Update: ) - Digestive System Diseases

Meckel's diverticulum is a permanent remnant of the vitellointestinal tract and is present in about 2 percent of people. It is located in the last part of the small intestine (antimesenteric side of the ileum). It is usually 60 cm from the ileocecal valve and is conventionally 5 cm long. Meckel diverticulum all three layers have an intestinal wall and their own blood supply.

Therefore, it is vulnerable to clogging and inflammation. Suspected appendicitis Meckel should be sought when a normal appendix is ​​found during surgery, especially if there is free fluid or inflammation.

Features of Meckel's diverticulum

  • Vitellointestinal tract residue
  • 2 inches (2 cm long) occurs in 5 percent of patients,
  • 2 feet (60 cm) from the ileocecal valve,
  • contains 20% heterotopic epithelium
  • In suspected appendicitis surgeries, Meckel should be sought when the appendix is ​​found to be normal.
  • If a Meckel is found incidentally during surgery, it can be left, provided the mouth is wide and not thickened.
  • May be a source of gastrointestinal bleeding if it contains ectopic gastric mucosa

In approximately 20 percent of cases, Meckel's diverticulum contains gastric mucosa, colonic heterotopic epithelium, or pancreatic tissue. Meckel can manifest clinically in the following ways:

  • Bleeding. If there is a stomach mucosa peptic ulcer as painless burgundy rectal bleeding may occur and may be present or melaena. If the stomach, duodenum and colon are cleansed endoscopyRadioisotope scanning with technetium-99m may show Meckel.
  • Diverticulitis. Meckel's diverticulitis is similar to appendicitis, but if perforation occurs it can resemble a perforated duodenal ulcer.
  • Intussusception. Meckel, ileoileal or ileocolic intussusception.
  • Chronic ulcer. Pain around the navel is felt. diverticulum region is of midgut origin.
  • Intestinal obstruction. A band (also the vitellointestinal tract) between the top of the diverticulum and the navel can obstruct directly or in the form of a volvulus.
  • Perforation.

The majority of Meckel is asymptomatic. If Meckel is found during abdominal surgery, he can be safely left alone, provided his mouth is wide and not thickened. Whenever there is doubt, it can be resected. Meckel's diverticulum groin (inguinal hernia) or inguinal (femoral hernia) hernias (Littre hernia).

Meckel diverticulectomy

A broad-based Meckel diverticulum should not be cut as there is a risk of stenosis and leaving heterotopic epithelium behind. It is safer to simply excise the diverticulum by resecting it. In large-based diverticula, it is safer to perform a segmental bowel resection followed by an anastomosis.

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