Meckels diverticulum is an embryological remnant of the connection between the intestines and yolk sac. It is present in about 2% of people and is located in the terminal ileum. Its size varies from 1 inch to 6 inches or more. The inner layers consist of normal intestinal components, but occasionally the mucosa may be of acid producing gastric mucosa. In most of the people the Meckels diverticulum may be asymptomatic. But some people may become symptomatic and it presents as 3 different clinical entities.
1. Acute appendicitis like picture, due to the diverticulum getting filled up with fecal matter and getting infected and inflamed.
2. Acute intestinal obstruction , due to the persistence of a band between the diverticulum and umbelicus.
3. Bleeding , due to the ectopic gastric mucosa which causes ulcerations and bleeding from intestines.
Diagnosis: Diagnosing the presence of Meckels diverticulum is very difficult preoperatively. Radio isotope scanning with Technicium may be useful, so is Barium meal follow through radiographs, but both are unreliable in diagnosing Meckels diverticulum. Laparotomy is the only procedure which is both diagnostic and therapeutic. Laparoscopy can also be done.
Treatment: Surgical exploration and removal of the diverticulum solves the problem. If there is ectopic gastric mucosa, nearby segment of the ileum is also removed.