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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 vitelline duct. It is the most common malformation of the gastrointestinal tract and is present in approximately 2% of the population, [ 1 ] with males more frequently experiencing symptoms.
On this site of attachment, sometimes a pathological Meckel's diverticulum may be present. A mnemonic used to recall details of a Meckel's diverticulum is as follows: "2 inches long, within 2 feet of ileocecal valve , 2 times as common in males than females, 2% of population, 2% symptomatic, 2 types of ectopic tissue: gastric and pancreatic".
The two can be differentiated as follows: a hamartoma is disorganized overgrowth of tissues in their normal location (e.g., Peutz–Jeghers polyps), while a choristoma is normal tissue growth in an abnormal location (e.g., osseous choristoma, [6] gastric tissue located in distal ileum in Meckel diverticulum).
A jejunal diverticulum is a congenital lesion and may be a source of bacterial overgrowth. It may also perforate or result in abscesses. A Killian-Jamieson diverticulum is very similar to a pharyngeal esophageal diverticulum, differing in the fact that the pouching is between the oblique and transverse fibers of the cricopharyngeus muscle. [7]
A Littre hernia is a very rare type of hernia which occurs when a Meckel's diverticulum protrudes through a defect in the abdominal wall. [1] It is named after French physician Alexis de Littre. [2] This hernia may occur in a number of anatomical locations, typically in the inguinal region (50%), umbilicus (20%) or femoral canal (20%).
gastric mucosa imaging for Meckel's diverticulum (especially in pediatrics). Examples of radionuclide therapeutic procedures are 131 I treatment of hyperthyroidism, 131 I treatment of thyroid cancer, and; radioimmunotherapy with 90 Y ibritumomab tiuxetan (Zevalin) & 131 I tositumomab (Bexxar) therapy of low-grade non-Hodgkin's lymphoma.
Type II: These cysts are present as an isolated diverticulum protruding from the CBD. Type III or Choledochocele: Arise from dilatation of duodenal portion of CBD or where pancreatic duct meets. Type IVa: Characterized by multiple dilatations of the intrahepatic and extrahepatic biliary tree.
Treatment [ edit ] Once suspected clinically and radiologically, patients with infertility and SIN can be managed with segmental resection with tubo-cornual anastomosis, and recanalization if tubal obstruction is detected.