Vitello intestine duct anomalies

1. Vitello-Intestine duct anomalies
NAWIN KUMAR
26-06-2014

2. Vitello-Intestinal Duct
• Syn. Omphalomesenteric duct
• Embryonic vitelline duct normaly gets
obliterated by 5th -9th week of IU life

3. Vitello intestinal duct anomalies
• Vitello-intestinal cord
• Persistent fistula
• Sinus
• Cyst
• Meckel’s diverticulum

6. Meckel’s diverticulum
• Most common congenital anomaly of small-
intestine
• In 2% population
• Rule of “2”
• Wide mouth / narrow mouth
• Pluripotent cells / ectopic epithelium

7. Clinical presentation
• Asymtomatic
• Haemorrhage – 25 to 50%
• Intestinal obstruction
• Diverticulitis

8. Haemorrhage from Meckel’s
diverticulum
• Patterns
– Acute massive haemorrhage
– Chronic bleeding, anaemia
– Recurrent self-limiting bleed
• Cause

9. Intestinal obstruction
• Volvulus
• Intussusception
• Hernia

10. • Meckel’s diverticulitis
• Neoplasms in Meckel’s diverticulum

11. Investigations for Meckel’s
diverticulum
• USG
• CT
• 99m Tc scan
– Sensitivity of 85%
– Specificity of 95%

13. Treatment
• Symptomatic Meckel’s diverticulum
– Resection with adjacent ileum
• Asymptomatic Meckel’s diverticulum
– Resection vs leaving alone