Question
A 59-year-old man present with rectal bleeding and offensive stool. Investigation reveals a Meckel’s diverticulum as shown in the given image. Which of the following is true regarding meckel’s diverticulum?
| A. |
It is usually found in the jejunum on the antimesenteric border & is approximately 5 cm long
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| B. |
It is 60 cm away from the ileocecal valve
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| C. |
It is seen in 2% people, usually presenting a patient over 2 years of age
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| D. |
It involves 2 two layers of the intestinal wall only
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Show Answer
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Correct Answer � B
Explanation
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Answer B) It is 60 cm away from the ileocecal valve
Meckel’s diverticulum
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A Meckel’s diverticulum, a true congenital diverticulum, is a slight bulge in the small intestine present at birth and a vestigial remnant of the omphalomesenteric duct (also called the vitelline duct or yolk stalk).
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It is the most common malformation of the gastrointestinal tract and is present in approximately 2% of the population, with males more frequently experiencing symptoms.
Signs & Symptoms
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The majority of people with a Meckel’s diverticulum are asymptomatic. An asymptomatic Meckel’s diverticulum is called a silent Meckel’s diverticulum.
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If symptoms do occur, they typically appear before the age of two years.
- The most common presenting symptom is painless rectal bleeding such as melaena-like black offensive stools,followed by intestinal obstruction, volvulus and intussusception.
Pathophysiology
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Meckel’s diverticulum is located in the distal ileum, usually within 60–100 cm (2 feet) of the ileocecal valve.
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This blind segment or small pouch is about 3–6 cm (2 inch) long and may have a greater lumen diameter than that of the ileum.
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It runs antimesenterically and has its own blood supply.
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It is a remnant of the connection from the yolk sac to the small intestine present during embryonic development.
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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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