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Paediatrics: Meckel’s diverticulum

A persistence of the embryonic vitelline duct that normally involutes during late foetal development.

Meckel’s diverticulum

 

Meckel’s diverticulm (MD) is:

A persistence of the embryonic vitelline duct that normally involutes during late foetal development.

 

Present in 2% of the population and the majority are asymptomatic.

 

A cause of GI bleeding, obstruction, inflammation, and umbilical discharge.

 

Management

 

Rectal bleeding from a MD is painless, fresh, and sufficient to cause a drop in haemoglobin. Sometimes a 99mTc-pertechnetate isotope scan will identify a MD.

·Laparotomy: persistent or recurrent bleeding requires a laparotomy even if the scan is –ve. Diverticulitis or perforation of a MD is clinically indistinguishable from appendicitis.

 

Symptomatic MD should be resected.

 

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