Small bowel (small intestine) - Meckel’s diverticulum

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Small bowel (small intestine)

Congenital anomalies

Meckel’s diverticulum

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 13 December 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Most prevalent congenital abnormality of GI tract, in 2% of normal population
● Usually asymptomatic, but also abdominal pain of unknown etiology (Rev Esp Enferm Dig 2011;103:250)
● Due to persistence (failure to involute) of proximal vitelline duct (also called omphalomesenteric duct, connects lumen of fetal intestine to yolk sac)
● Normally, vitelline duct atrophies and becomes fibrous cord connecting umbilicus and bowel, which is subsequently absorbed
● 63% occur in males
● Usually 20 cm proximal to ileocecal valve on antimesenteric side of bowel, 1-8 cm long (Clin Anat 2011;24:416)
● Associated with other congenital anomalies
● Complications: perforation, enteroumbilical fistula, peptic ulceration (usually in adjacent ileum and not in diverticulum), hemorrhage (often massive in children), intussusception, obstruction, carcinoid and other tumors

Case reports
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● 22 year old woman with Crohn’s disease within Meckel's diverticulum (Arch Pathol Lab Med 2003;127:E99)

Treatment
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● Remove if found at surgery, even if incidental

Gross images
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Meckel's diverticulum

Micro description
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● Usually small intestinal mucosa, but 50% have gastric or pancreatic heterotopia
● Contains all 3 layers of bowel wall

Micro images
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With pancreatic heterotopia

End of Small bowel (small intestine) > Congenital anomalies > Meckel’s diverticulum

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