MECKEL’S DIVERTICULUM

**MECKEL’S DIVERTICULUM **

Definition:

• Meckel's diverticulum is a congenital diverticulum of the small intestine, specifically the ileum.
• It is a pouch-like structure that protrudes from the wall of the ileum.
• The diverticulum is a remnant of the omphalomesenteric duct (also known as the vitelline duct).

Types:

• True diverticulum (most common): the pouch-like structure contains all layers of the intestinal wall.
• False diverticulum: the pouch-like structure contains only mucosa and submucosa.

Pathology:

• The omphalomesenteric duct usually obliterates during the 6th week of gestation.
• If the duct remains patent, a Meckel's diverticulum forms.
• The diverticulum can contain ectopic gastric or pancreatic tissue.

Causes:

• Patency of the omphalomesenteric duct during fetal development
• Failure of the duct to obliterate
• Genetic factors

Clinical Features:

• Often asymptomatic
• Abdominal pain
• Gastrointestinal bleeding (due to ectopic gastric tissue)
• Intussusception
• Obstruction
• Diverticulitis

Investigations:

• Barium studies
• Ultrasound
• CT scan
• Meckel's scan (technetium-99m pertechnetate scan)
• Endoscopy

Complications:

• Intestinal obstruction
• Diverticulitis
• Bleeding
• Intussusception
• Perforation
• Perforation with peritonitis

Management:

• Conservative management for asymptomatic cases
• Surgical resection for symptomatic cases
• Resection of the diverticulum and adjacent ileum

Treatment:

• Surgical resection of the diverticulum
• Closure of the mesenteric defect
• Anastomosis of the ileum

Surgical Steps: 1 → Exploration of the abdomen 2 → Identification of the Meckel's diverticulum 3 → Resection of the diverticulum and adjacent ileum 4 → Closure of the mesenteric defect 5 → Anastomosis of the ileum

Homoeopathic Therapeutic Medicines:

• Lachesis: for pain and inflammation
• Calcarea carbonica: for bleeding and anemia
• Silica: for bowel obstruction and diverticulitis
• Graphites: for chronic abdominal pain and constipation

Note: Homoeopathic medicines are not a substitute for surgical treatment.