Meckel's diverticulum

Meckel's diverticulum, otherwise known as the ileum diverticulum, is a congenital anomaly of the small intestine that is associated with the pathology of the inverse development of the bile duct in its proximal part. Unclosed (unlicensed) remains the proximal part of it, as a result, there is a duct between the intestine and the navel.

Yolk and urinary embryonic ducts function in the first weeks of intrauterine development of the human body, which are in the umbilical cord. The fetus feeds through the first, because it connects the yolk sac to the intestine of the fetus, and through the second urine flows into the amniotic fluid. In the period from the third to fifth months of intrauterine life, their reverse development occurs, - yolk, gradually becoming atrophy, turns into a middle ligament.

If certain failures have occurred in the mechanism of this transformation, then gradually, depending on the degree of preservation of the un-littered duct and the level of location of the pathology:

• Full or incomplete navel fistulas;
• Meckelian diverticulum;
• Enterokristoma.

This anomaly was discovered in the early nineteenth century by Johann Friedrich Meckel, Jr., a German anatomist from the city of Halle.

He described the differences between the two small intestine diverticula:

• Acquired and consisting exclusively of mucosa, located on its mesenteric side;
• A true diverticulum, congenital, which captures all layers of its wall and departs antiseizenterially.

Diverticulum of the small intestine is classified as follows:

By the degree of persistence of the duct:

1) is fully open;

2) partially open:

- if from the side of the intestine, then the diverticulum of Meckel;

- if from the navel, then omphalocele;

- If in the middle, then enterokristoma.

3) closed completely.

Of all the above listed forms, Meckel's diverticulum occurs more often than others, in 70% of cases, and, respectively, from 1% to 4% of the total population. And in men he is diagnosed in 2, and in case of complications, then 5 times more often than in women. Fifty percent of cases are detected in children under the age of ten, the rest - in young people under thirty. The diverticulum of Meckel in twelve percents of cases is combined with other pathologies of development, but family occurrence is not proved.

Its length is on the average from two to three centimeters, the minimum size is 1 cm, and the maximum - 26 cm, as thick as a finger and narrow as a worm-like process. In shape resembles a cylinder or cone. Usually Meckel's diverticulum is located on the opposite mesentery to the side of the ileum, antimisenterially. The average distance from it to the Bauginium damper is from 40 to 50 cm, can be braided from the connective tissue with the anterior abdominal wall, mesentery or with intestinal loops.

Clinically, in most cases, it does not manifest at all, but it is detected mainly in the course of operations on the abdominal cavity for other reasons or in the case of complications.

The diagnosis is confirmed by an X-ray study using barium sulfate suspension as a contrast agent. As one of the auxiliary methods, ultrasound can be used. There is also a specific method of research - radioisotope scintigraphy using technetium-99. When bleeding from Meckel's diverticulum, the diagnosis is established using arteriography.

Treatment operative, in the event that it is small, then the technique of removal is the same as in the operation of apendectomy. But in the case of a wide diverticulum with a mesentery, the latter is bandaged, crossed, and, applying a soft intestinal pulp, the diverticulum itself is cut off. Then the wound of the intestines and the abdominal cavity are sutured .

And what is diverticulosis?

This is the state of the body in which diverticula of the large intestine are formed, that is, numerous protrusions of the saccular form that communicate with the cavity of the colon (more often in the duodenum). They appear clinically only in the case of complications, it is treated surgically.