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MCQ – 88471

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
B.

It is 60 cm away from the ileocecal valve

C.

It is seen in 2% people, usually presenting a patient over 2 years of age

D.

It involves 2 two layers of the intestinal wall only

Show Answer

Correct Answer � B

Explanation

Answer B) It is 60 cm away from the ileocecal valve

Meckel’s diverticulum

  • 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).

  •  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

  • The majority of people with a Meckel’s diverticulum are asymptomatic. An asymptomatic Meckel’s diverticulum is called a silent Meckel’s diverticulum. 

  • 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

  • Meckel’s diverticulum is located in the distal ileum, usually within 60–100 cm (2 feet) of the ileocecal valve. 

  • 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.

  • It runs antimesenterically and has its own blood supply. 

  • 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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