Uncommon complication of meckels diveiculum is: September 2005
Correct Answer: Malignancy
Description: Ans. C: Malignancy Epidemiology - More common in males by ratio of 3:2 Lifetime complication rate: 4% - More than 50% of complications occur before age 10 History-Initial repo by Hildanus in 1598, Detailed description by Johann Meckel in 1809 Pathophysiology: Meckel's Diveiculum - Incomplete vitelline duct (omphalomesenteric) closure - Location . Proximal to ileocecal valve by 100 cm Usually within 45 to 60 cm of ileocecal valve Differential Diagnosis of Meckel's Diveiculitis-Appendicitis Complications of Meckel's Diveiculum - GI Bleeding (25-50% of complications) Often associated with ectopic gastric mucosa Hemorrhage is most common presentation under age 2 - Meckel's Diveiculitis (10-20% of complications)-Similar in presentation to Appendicitis - Bowel Obstruction Volvulus at fibrotic band attached to abdominal wall Intussusception Incarcerated Inguinal Hernia (Littre's hernia) - Other complications-Carcinoid Tumor Radiology - Radionuclide Scintigraphy (Sodium Tc-peechnetate) Preferential uptake by gastric tissue Most accurate test in Meckel's Diveiculum-Test Sensitivity is 85% in children and Test Specificity is 95% in children Less accurate in adults -Cimetidine increases accuracy in adults - Small bowel enema-Indicated for negative scintigraphy in adults - Aeriography (indicated for acute hemorrhage)
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