DIVERTICULO DE MECKEL PDF

Clinical features Patients usually present with acute pain in the right lower quadrant. Painless rectal bleeding is also frequent. Pathology A number of mechanisms are recognized as precipitants of diverticulitis. Meckel diverticulitis can occur due to bacterial infection, which can go on occasionally to gangrene.

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Clinical features Patients usually present with acute pain in the right lower quadrant. Painless rectal bleeding is also frequent. Pathology A number of mechanisms are recognized as precipitants of diverticulitis. Meckel diverticulitis can occur due to bacterial infection, which can go on occasionally to gangrene.

This is similar in pathogenesis to acute appendicitis or colonic diverticulitis. Peptic ulceration due to acid secretion from gastric mucosa see Meckel diverticulum or diverticular torsion is also encountered.

Radiological features Ultrasound Meckel diverticula are usually seen as tubular incompressible blind ending hypoechoic structure with irregular margins. Occasionally it may also be seen as a cyst, raising a different differential diagnosis of intestinal duplication which however is said to have regular margins 2. Doppler may reveal anomalous vessels and signs of inflammation along the diverticulum.

CT CT is the main modality employed in imaging patients with acute abdominal pain and signs of inflammation. Mural wall thickening and enhancement are seen with surrounding inflammatory changes in the adjacent fat as well as small reactive mesenteric lymph nodes. Wall enhancement will be absent in gangrenous Meckel diverticulum. Rarely, an enterolith can also be visualized within the diverticulum. As is the case with appendicitis , it is said that contrast opacification of diverticula is suggestive of inflammation.

Reporting checklist Identification of Meckel diverticulitis requires not only familiarity with the condition but also a careful examination of the small bowel. Nuclear medicine pertechnetate scan Ectopic gastric mucosa, if present, can be picked up on this scan, but again does not usually play a role in the acute presentation.

Differential diagnosis Clinically the differential diagnosis is broad, and unless a Meckel diverticulum is known to be present, Meckel diverticulitis is usually not specifically suspected. Imaging can also be challenging, with the most common differentials including: identifying a normal appendix is thus crucial terminal ileitis.

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Diverticul Meckel

The vitelline duct narrows progressively and disappears between the 5th and 8th weeks gestation. The right becomes the superior mesenteric artery that supplies a terminal branch to the diverticulum, while the left involutes. It is a remnant of the connection from the yolk sac to the small intestine present during embryonic development. It is a true diverticulum, consisting of all 3 layers of the bowel wall which are mucosa , submucosa and muscularis propria.

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