Meckel's diverticulum is a congenital diverticulum of the small intestine. It is a remnant of the omphalomesenteric duct (also called the vitellointestinal duct) and contains ectopic ileal, gastric or pancreatic mucosa

Pathophysiology

• normally, in the foetus, there is an attachment between the vitellointestinal duct and the yolk sac. This disappears at 6 weeks gestation
• the tip is free in the majority of cases
• associated with enterocystomas, umbilical sinuses, and omphaloileal fistulas.
• arterial supply: omphalomesenteric artery.
• typically lined by ileal mucosa but ectopic gastric mucosa can occur, with the risk of peptic ulceration. Pancreatic and jejunal mucosa can also occur.

Rule of 2s

• occurs in 2% of the population
• is 2 feet from the ileocaecal valve
• is 2 inches long
• Age of presentation is usually 2

PC

(usually asymptomatic)

• abdominal pain mimicking appendicitis
• rectal bleeding
  • Meckel's diverticulum is the most common cause of painless massive GI bleeding requiring a transfusion in children between the ages of 1 and 2 years
• intestinal obstruction
  • secondary to an omphalomesenteric band (most commonly), volvulus and intussusception