Meckels Ulcer

Meckel's diverticulum results from postnatal incomplete obliteration of the omphalomesenteric duct adjacent to the intestine. In adults, it is located in the ileum 30-100 cm from the ileocecal valve and on the side opposite to the mesentery. A diverticular intestine on the mesenteric side is likely to be intestinal duplication (see "Advice, Intestinal duplication," below). Gastric acid secreted from the fundic gland of the ectopic gastric mucosa in the diverticulum may cause ulcers of the diverticulum or the ileal mucosa in the vicinity of the diverticulum, leading to abdominal pain, gastrointestinal bleeding, or gastrointestinal perforation. It may also cause intestinal obstruction, intussusception, or diverticulitis (Fig. 10.4.4).

Fig. 10.4.4. Meckel's diverticulum in a 19-year-old man a Meckel's diverticulum with an ulcer of its opening in the ileum b Selective, contrast-enhanced radiograph. Meckel's diverticulum is enhanced at the arrow

Fig. 10.4.4. Meckel's diverticulum in a 19-year-old man a Meckel's diverticulum with an ulcer of its opening in the ileum b Selective, contrast-enhanced radiograph. Meckel's diverticulum is enhanced at the arrow

Advice

Intestinal Duplication

Intestinal duplication may occur in any region of the gastrointestinal tract, and there are many theories to explain the occurrence. The small intestine and the ileocecal region are often involved. Ectopic gastric mucosa may be found. In clinical practice, this condition often manifests as an intestinal obstruction due to direct compression of the adjacent intestine or intussusception with intestinal duplication as a lead point.

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