Meckel’s diverticulum


All are true regarding meckel’s diverticulum except


A. It is the most common congenital malformation of the gastrointestinal tract
B. The most common complication in adult patients is bleeding
C. It is the most common cause of bleeding in the pediatric age group
D. It is a true diverticulum



Littre’s hernia’ containing meckel’s diverticulum is frequently found with hernia of following region


A. Inguinal
B. Umbilical
C. Femoral
D. Incisional



Technetium-99m pertechnate scan is the most common and accurate non-invasive investigation of meckel’s diverticulum as it concentrates in



A. Ectopic gastric mucosa
B. Ectopic pancreatic acinar cells
C. Submucosal fibrosis
D. Chronic ulcerations



All are true of meckel’s diverticulectomy except


A. Simple diverticulitis with short meckel’s diverticulum needs wedge resection
B. Complicated diverticulitis with perforated base is dealt by segmental resection
C. When the indication of surgery is bleeding wedge resection is not sufficient
D. Incidentally discovered MD, routine resection is not indicated



In short



The most common complications of meckel’s diverticulum in adults include intestinal obstruction and diverticulitis.


Treatment of symptomatic MD is definitive surgery including diverticulectomy, wedge resection and segmental resection; the type of procedure depends on the integrity of diverticulum base and adjacent ileum as well as the presence and the location of ectopic tissue within MD.


63% of bleeding diverticula in adults contain ectopic gastric mucosa.


MD can cause intestinal obstruction by: (a) volvulus of small intestine (b) ileoileal and ileocolic intussusception; (c) incarceration of MD in an inguinal or femoral hernia known as complicated Littre’s hernia; (d) axial torsion, (e) entrapment of small bowel beneath a mesodiverticular band; (f) stricture secondary to chronic diverticulitis;(g) MD lithiasis (enterolith, bezoar), (h) entrapment of small bowel, (i) tumors


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