ABSTRACT

Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract and the most common cause of serious gastrointestinal bleeding in children. Anatomically, it is an outpouching on the antimesenteric border of the small bowel (Figure 44.1). Although first reported by Fabricus Hildanus in 1598, this abnormality derives its name from Johann Friedrich Meckel, who in 1809 detailed its embryological origin and identified it as a potential cause of disease.1,2 Reports estimate that Meckel’s diverticulum affects 2% of the general population. However, it is usually clinically silent, identified only as an incidental finding during laparotomy, laparoscopy, or at autopsy. Estimates of the life-

time risk of complications occurring range from 4 to 6%.3-5 These complications are usually due to ectopic tissue within the diverticulum or to omphalomesenteric or mesodiverticular bands. The clinical presentation of Meckel’s diverticulum is diverse. Symptoms often mimic those associated with other more common abdominal disorders, making preoperative diagnosis quite difficult. This chapter focuses on the major complications of this anomaly, describing its pathogenesis, diagnosis and management. Relevant embryology, histology and epidemiology will set the stage for this discussion.