Inflammation of Meckel diverticulum may produce symptoms resembling:
Ans: a (Appendicitis) Ref: Bailey, 24th ed, p. 1159As Meckel's diverticulum possesses all three coats of intestinal wall and has its own blood supply, it is vulnerable to infection and obstruction in the same way as appendix and produces clinical pictures similar to appendicitis.Meckel diverticulumSituated in the antimesentric border of the small intestine.Commonly 60 cm from ileocaecal valve.3 - 5 cm long.Rule of two- 2% prevalence- 2 inch in length- 2 feet proximal to ileocaecal valve- Half of those who are symptomatic are younger than 2 yrs of age.True diverticula having all 3 layers.Represents the patent intestinal end of vitellointestinal duct.Male to female ratio 3:1.Approximately 60% contain heterotrophic mucosa of which more than 60% consists of gastric mucosa.Second most common ectopic mucosa is that of pancreas.ComplicationsMost common complication- In children and young adult (< 18 yrs) - bleeding- In adults - intestinal obstruction- Overall - bleedingSymptoms (asymptomatic and complication produces symptoms)1) Severe haemorrhage (most common)2) Intussusception.3) Meckel diverticulitis- Clinical picture is similar to appendicitis.- Diverticulitis may lead to perforation.Points- It should be sought when a normal appendix is found at surgery for suspected appendicitis.- If a silent Meckel's is found incidentally during the course of an operation, it can be left alone provided it is wide mouthed and not thickened.InvestigationSmall bowel barium enema is the most accurate investigation.Technitium- 99 m scanning - May localise heterotrophic gastric mucosa.
Appendicitis
Colitis
Gastroenteritis
Intestinal obstruction
Small & Large Intestine