investigation and management
Most frequently, a Meckel's diverticulum is asymptomatic and does not cause any clinical manifestations. In other cases it is only diagnosed at operation, e.g. if presenting in a similar manner to acute appendicitis. Radiographically, Meckel's diverticuli are difficult to diagnose when symptomatic because of oedema around the opening into the intestinal lumen - this may prevent contrast entering the diverticulum. If bleeding is occurring from an ectopic gastric mucosal site, a technetium scan may localise this.
The treatment of the diverticulum is dependent on cause. Co-incidentally-found diverticuli with wide necks should be left undisturbed. Diverticulectomy is indicated if there is inflammation, ulceration, perforation or a narrow neck. It involves ligation of the omphalo-mesenteric artery and vein, and the removal of a portion of adjacent ileum which may also contain ectopic gastric mucosae.
Last reviewed 01/2018