Uncommon complication of meckels diveiculum is:September 2005
Ans. C: MalignancyEpidemiology- More common in males by ratio of 3:2Lifetime complication rate: 4%- More than 50% of complications occur before age 10History-Initial repo by Hildanus in 1598, Detailed description by Johann Meckel in 1809Pathophysiology: Meckel's Diveiculum- Incomplete vitelline duct (omphalomesenteric) closure- Location. Proximal to ileocecal valve by 100 cmUsually within 45 to 60 cm of ileocecal valveDifferential Diagnosis of Meckel's Diveiculitis-AppendicitisComplications of Meckel's Diveiculum- GI Bleeding (25-50% of complications)Often associated with ectopic gastric mucosaHemorrhage is most common presentation under age 2- Meckel's Diveiculitis (10-20% of complications)-Similar in presentation to Appendicitis- Bowel ObstructionVolvulus at fibrotic band attached to abdominal wallIntussusceptionIncarcerated Inguinal Hernia (Littre's hernia)- Other complications-Carcinoid TumorRadiology- Radionuclide Scintigraphy (Sodium Tc-peechnetate)Preferential uptake by gastric tissueMost accurate test in Meckel's Diveiculum-Test Sensitivity is 85% in children and Test Specificity is 95% in childrenLess accurate in adults -Cimetidine increases accuracy in adults- Small bowel enema-Indicated for negative scintigraphy in adults- Aeriography (indicated for acute hemorrhage)
Intussusception
Diveiculitis
Malignancy
Increased bleeding