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Key Features

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  • Most common form of omphalomesenteric duct remnant

  • Usually located on the antimesenteric border of the mid to distal ileum

  • Occurs in 1.5% of the population

  • Familial cases have been reported

  • If complications occur, they are three times more common in males than in females

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Clinical Findings

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  • Asymptomatic is most cases

  • Forty to 60% of symptomatic patients have painless episodes of maroon or melanotic rectal bleeding

  • Bleeding may be voluminous enough to cause shock and anemia

  • Occult bleeding is less common

  • Intestinal obstruction occurs in 25% of symptomatic patients as a result of ileocolonic intussusception

  • Intestinal volvulus may occur around a fibrous remnant of the vitelline duct extending from the tip of the diverticulum to the abdominal wall

  • Meckel diverticula may be trapped in an inguinal herni

  • Diverticulitis is clinically indistinguishable from acute appendicitis

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Diagnosis

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  • Diagnosis of Meckel diverticulum is made with a Meckel scan

  • Technetium-99 (99mTc)-pertechnetate

    • Taken up by the heterotopic gastric mucosa in the diverticulum

    • Outlines the diverticulum on a nuclear scan

    • Sensitivity of test can be increased by giving pentagastrin or cimetidine before 99mTc-pertechnetate

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Treatment

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  • Surgical

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