Meckel's diverticulum, all are true except -
Ans. is 'c' i.e., Consists of mucosa without a muscle coat Meckel's diverticulum is situated at the anti-mesenteric border of small intestine. o Meckel's diverticulum is a true diverticulum as it has all the 3 layers of the intestine, o it's the most common congenital anomaly of the gastrointestinal tract. o Male to female ratio is 3 : 2. o Approximately 60% of Meckel's diverticula contain heterotopic mucosa, of which more than 60% consists of gastric mucosa. Second most common ectopic mucosa is that of Pancreas (Pancreatic acini). Other mucosa are:- colonic mucosa, Brunner's gland, pancreatic islets, endometriosis and hepatobiliary tissue, o A useful but crude Mnemonic used traditionally for describing Meckel's diverticula is Rule of two : i.e. 2% prevalence 2 Inch in length 2 Feet proximal to ileocecal valve. Half of these who are symptomatic are younger than 2 yrs of age o Meckel's diverticula are asymptomatic. Symptoms arise only when any complication occurs, o Complications o Most common complication y In children & young adults (< 18 yrs of age) y in adults y overall - - - Bleeding Intestinal obstruction Bleeding o Following complications are noted m Meckel s diverticulum. Bleeding Bleeding in Meckel's diverticulum is usually the result of ulceration in ileal mucosa adjacent to the diverticulum caused by the acid secreted by heterotopic gastric mucosa within the diverticulum. Intestinal obstruction Intestinal obstruction associated with Meckel's diverticulum can result from several mechanisms. Volvulus of the intestine around the fibrous band attaching the diverticulum to the umbilicus. Intussusception with the diverticulum acting as the lead point. Entrapment of intestine by a mesodiverticular band (mesodiverticular band is a remnant of the left vitelline artery, it tethers the Meckel's diverticulum to the ileal mesentery;.) Stricture secondary to chronic diverticulitis. 3) Diverticulitis The clinical picture is similar to appendicitis. Diverticulitis may lead to perforation. o Littre's hernia - Rarely Meckel's diverticulum is found in inguinal or a femoral hernia. This is known as Lit (re's hernia. o Diagnostic studies Meckel's diverticulum in the absence of bleeding can be rarely diagnosed before surgical intervention. Barium meal follow through can rarely demonstrate the diverticulum. Barium enteroclysis can demonstrate the diverticula in 75% of cases but is avoided during the acute presentation of complication. If repeated episodes of lower GI bleed occur and an ectopic gastric mucosa in the Meckel's diverticulum is suspected, it can be demonstrated by Technetium"pertechnate radionuclide scan. It demonstrates the ectopic gastric mucosa and localizes the Meckel's diverticulum. Angiography can localize the site of bleeding during acute hemorrhage related to meckeiMeckel'sticula.
Present in 2% population
Lies on the antimesenteric border
Consists of mucosa without muscle
Contains ectopic gastric tissue