Meckel's Diverticulum Diagnosis and Surgical Management
Summary
Meckel's diverticulum, the most prevalent congenital anomaly of the small intestine, arises from incomplete obliteration of the vitelline (omphalomesenteric) duct. Present in roughly 2% of the population, it often contains ectopic gastric or pancreatic tissue, which may lead to ulceration, gastrointestinal bleeding, obstruction or inflammation. Clinical manifestations vary with age: children frequently present with painless lower-gut bleeding or intussusception, while adults are more prone to diverticulitis or chronic abdominal pain. Diagnostic assessment combines anatomical and functional imaging—ranging from ultrasound and conventional computed tomography to dedicated enterography and radionuclide scintigraphy targeting ectopic mucosa. Therapeutic intervention is surgical, with options including simple diverticulectomy or segmental ileal resection based on tissue involvement and blood supply. Minimally invasive techniques have become standard, offering reduced postoperative pain and shorter hospital stays. However, the management of incidentally discovered, asymptomatic diverticula remains debated, balancing prophylactic removal against operative risk.
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Meckel's Diverticulum Diagnosis and Surgical Management publication trend
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Technical terms
Ectopic gastric mucosa: Gastric lining tissue located outside the stomach, often within Meckel's diverticulum, which can secrete acid and cause ulceration.
Computed tomography enterography: A specialised CT technique using oral and intravenous contrast to enhance visualisation of the small bowel and identify sources of bleeding or inflammation.
Technetium-99m pertechnetate scintigraphy: A nuclear medicine scan that detects uptake by gastric mucosa, aiding in non-invasive identification of Meckel's diverticulum containing ectopic gastric tissue.
Prophylactic resection: Elective surgical removal of an asymptomatic diverticulum to prevent future complications, the merits of which remain under discussion.
References
- Ectopic “Ectopic” Gastric Mucosa. Diagnostics (2024).
- Systematic review of epidemiology, presentation, and management of Meckel's diverticulum in the 21st century. Medicine (2018).
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