Vitello-Intestine duct anomalies

NAWIN KUMAR26-06-2014

Vitello-Intestinal Duct

• Syn. Omphalomesenteric duct

• Embryonic vitelline duct normaly gets obliterated by 5th -9th week of IU life

Vitello intestinal duct anomalies

• Vitello-intestinal cord

• Persistent fistula

• Sinus

• Cyst

• Meckel’s diverticulum

Meckel’s diverticulum

• Most common congenital anomaly of small-intestine

• In 2% population

• Rule of “2”

• Wide mouth / narrow mouth

• Pluripotent cells / ectopic epithelium

Clinical presentation

• Asymtomatic

• Haemorrhage – 25 to 50%

• Intestinal obstruction

• Diverticulitis

Haemorrhage from Meckel’sdiverticulum

• Patterns

– Acute massive haemorrhage

– Chronic bleeding, anaemia

– Recurrent self-limiting bleed

• Cause

Intestinal obstruction

• Volvulus

• Intussusception

• Hernia

• Meckel’s diverticulitis

• Neoplasms in Meckel’s diverticulum

Investigations for Meckel’sdiverticulum

• USG

• CT

• 99m Tc scan

– Sensitivity of 85%

– Specificity of 95%

Treatment

• Symptomatic Meckel’s diverticulum

– Resection with adjacent ileum

• Asymptomatic Meckel’s diverticulum

– Resection vs leaving alone