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View Full Version : Meckel's Diverticulum (Aetiology-Pathology-Complications-Investigations-Treatment)



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04-26-2008, 11:41 AM
m Aetiology: Persistance of proximal part of vitillointestinal duct.
mPathology: Disease of Two (2 x 8)
Incidence:
- 2% of population.
- 2% of them show symptoms (Complications occur in 2% of cases).
- 2 inches in length.
- 2 feet from the ileocecal valve.
- 24 = 16% of cases show ectopic gastric glands and pancreatic tissue
in its wall.
- 2 times common in male than female.
- Gives 2 major complications Hge. and inflammation.
m Complications:
1- Acute inflammation:"Diverticulitis"
symptoms similar to acute appendicitis.
2- Peptic ulceration: bleeding /rectum in children.
Rare cause so, we must exclude other causes of bleeding per rectum before diagnosis.
3- Mucocele: obstruction at the neck without infection gives mucocele felt in the abdomen as cystic mass
4- Intestinal obstruction by one of the following :










a -Intussuception initiated in the diverticulum.
b- Internal herniation into an opening formed by adhesion between it
and intestine.
c-Volvulous.around a band attached from the tip of the deverticulum
to the umblicus.
5- Strangulation without obsturction: In (Littre's hernia)
mInvestigations:
Small bowel enema; can localize site of the diverticulum.
Technicium 99m scanning; can localize the site of ectopic gastric glands in cases of unexplained recurrent bleeding /rectum.






mTreatment:
I- Complicated: Excision:
a- Narrow neck Excision with V shaped incision at its neck.
b- Wide neck Excision with the segment of ileum then anastomosis.
II- Not Complicated: During exploration for another operation
a- If general condition is good Resect it.
b- If general condition is bad Give the patient report about Mickle's
SOURCE: DR. AYMAN SALEM'S BOOK
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