Meckel's diverticulum is the most common congenital malformation of the gastrointestinal tract. Most often, its presence does not cause any symptoms and it is - if at all - detected by accident, but sometimes it happens that a patient with this diverticulum has gastrointestinal bleeding or pain. What exactly is Meckel's diverticulum, why does it occur in some people, and what problems may it develop in patients who have it?

Meckel's diverticulum(akaileal diverticulum ) is the most common congenital abnormality in the gastrointestinal tract - it is generally estimated that that about 2% of the population has it. The name of this creature comes from the name of Johan Friedrick Meckel, who was not the discoverer of the diverticulum, but it was this anatomist who for the first time accurately described its structure and embryological origin.

Meckel's diverticulum can occur in both women and men - in the past it was thought to be more common in men. It is now known that most likely this type of defect occurs with a similar frequency in representatives of both sexes. In men, the presence of a diverticulum - for unknown reasons - more often leads to the occurrence of various ailments, therefore, in them the presence of Meckel's diverticulum is simply detected more often.

Meckel's diverticulum: embryology

In the course of embryonic development, three parts are distinguished from the prajelite:

  • anterior intestine,
  • middle
  • and back.

The second of these, i.e. the middle intestine, connects to the yolk sac through the yolk duct - between the 2nd and 5th week of fetal life, nutrients are transported to the embryo by this route.

After a short time, the nutritional function is taken over by the placenta and, under normal conditions, the yolk-intestinal tract is closed. If it does not happen between the 7th and 8th week of fetal life, various congenital abnormalities may develop, such as The umbilical fistula or the Meckel's diverticulum.

Meckel's diverticulum: anatomy

Meckel's diverticulum is a true diverticulum, meaning it is made up of all three intestinal walls. It is located in the last section of the ileum, usuallyapproximately 60 cm from the ileocecal valve (this distance, however, can range from 30 to 100 cm). Typically the length of a Meckel's diverticulum is about 5 cm, but it can be as much as 50 cm.

Inside the diverticulum there may be typical intestinal cells as well as various ectopic tissues - this kind of situation occurs even in 60% of cases.

The gastric epithelium is the most common foreign mucosa in Meckel's diverticulum, with pancreatic cells being the second most frequent ectopic weaving.

Meckel's diverticulum: symptoms and diseases

In most, 60 to 85% of people, the presence of Meckel's diverticulum does not cause any symptoms. However, some problems, unfortunately, may occur. The most common ailment in this case is gastrointestinal bleeding - people with ectopic gastric tissue within the diverticulum are especially predisposed to it.

This epithelium - through the production of hydrochloric acid - can lead to the development of ulcers, the consequence of which may be bleeding.

The second most common problem with Meckel's diverticulum is intestinal obstruction. It can occur due to the twisting of the intestinal loops around the diverticulum, as well as when Meckel's diverticulum becomes trapped in an inguinal hernia.

Typical symptoms of this condition are abdominal pain, nausea, vomiting, and gas and stool retention.

Other, much rarer complications of the presence of Meckel's diverticulum include perforation and Meckel's diverticulitis. Very rarely, this diverticulum is the primary location of a neoplastic tumor.

It is worth mentioning here that the risk of complications resulting from having a Meckel diverticulum depends on the age. The ailments most often appear in children, with age the risk of complications gradually decreases more and more.

Meckel's diverticulum: diagnosis

In people in whom Meckel's diverticulum does not generate any ailments, its presence is confirmed accidentally (e.g. during an operation) or not at all. The situation is different in patients who develop some symptoms, e.g. severe abdominal pain or bleeding from the gastrointestinal tract.

They usually have a diverticulum, although it should be noted here that it is also rather accidental - the ailments related to the presence of a diverticulum are non-specific and rather suggest other diseases, such as

  • gastric ulcer,
  • appendicitis
  • Is intestinal diverticulosis.

Meckel's diverticulum usually visualizedstays during the operation (e.g. when the patient is operated on because of suspected appendicitis).

Unfortunately, imaging tests have a low effectiveness in detecting the existence of a diverticulum (the formation may be considered as part of a normal intestine). However, the literature mentions the usefulness of scintigraphy in the diagnosis of Meckel diverticula with ectopic gastric tissue.

Meckel's diverticulum: treatment

Just as the existence of a Meckel's diverticulum in a patient can cause a wide variety of ailments, only one method is used in the treatment. We are talking about diverticulum resection, which can be performed laparoscopically.

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Category:

Gastrology