Meckel's diverticulum is a congenital abnormal disease of the ileum, which can significantly affect human health or not manifest itself at all during life. With non-professional diagnosis, diverticulum of this type is often mistaken for a number of other disorders, such as appendicitis, peptic ulcer and others.
What is Meckel's diverticulum and the ICD-10 disease code
In medicine, Meckel's diverticulum is called an abnormal sac that develops in a weak area of the intestine. This problem occurs due to impaired obliteration of the proximal part of the bile duct.
So, in the first month of development, the yolk duct begins to function actively in the fetus. It connects the terminal portion of the ileum and the yolk sac. Due to abnormal development of the fetus and the incomplete obliteration, as well as the preservation of the bile duct, protrusion appears. Fistulas of the navel and enterokrostoma can also occur.
The photo clearly shows the diverticulum of Meckel
The insidiousness of the ailment lies in the fact that it is difficult enough to diagnose it on time.
In most cases, the diverticulum has an asymptomatic course and manifests itself at a fairly late age. Diverticulum forms in the lower third of the intestine at a distance of about 60 cm from the iliac angle. The formation has a cylindrical or conical shape, its dimensions usually do not exceed 3 cm in length.
Meckel's diverticulum MKB code Q43.0 refers to the classification of diseases that treats bowel developmental malformations. This pathology, despite its little popularity, has a fairly wide prevalence. Anomaly is detected in 1 out of 50 people.
Causes of development of
Meckel diverticulum is a deviation that forms in the process of embryo development. So, in the first weeks of fetal formation, the yolk duct, which departs from the terminal part of the ileum to the navel, is obliterated. If a part of the duct does not atrophy for a certain period of time, then a diverticulum occurs.
Meckel's diverticulum refers to congenital diseases. The protrusion is located on the mesentery of the mesentery of the intestine. It contains all the layers of a normal and fully functioning gut. It is impossible to prevent or predict the development of the disease in advance.
Symptoms of
Symptomatic manifestations of protrusion directly depends on the basis on which the diverticulum's body is formed. The most commonly developed formation consists of intestinal cells. It is capable of producing hydrochloric acid, as well as ectopic mucus.
Thus, the diverticulum can function as a full component of the intestine. This type of disease does not manifest itself symptomatically, does not bother the person and does not cause him any inconvenience.
It is possible to detect the presence of a deviation only after carrying out a special diagnosis, since a routine study is unable to recognize the disease. In other cases, the diverticulum may consist not only of intestinal cells. The formation can be formed from the cells of the stomach and pancreas.
However, the diverticulum of Meckel can manifest itself more aggressively. Symptoms may occur as follows:
- vomiting;
- constipation;
- intestinal blockage;
- periodic stool disorders;
- fever;
- pain in the intestines, which have a prolonged nature;
- malaise;
- weakness;
- internal bleeding;
- presence of blood in stool;
- anemia;
- a constant feeling of discomfort in the intestines.
The protrusion can manifest itself periodically. In some cases, the symptoms may subside and re-activate. These symptoms include nausea, bloody stools and bowel disorder.
Complications of
Complications of Meckel's diverticulum are not observed often. About 2%, suffering from such a disease, can observe the deterioration, which affects the entire state of the body.
Despite the fact that the anomaly manifests itself in both men and women, complications often appear in the representatives of the strong side.
Complications can be expressed in the following manifestations:
- bleeding;
- obturation;
- tumors and neoplasms;
- intestinal obstruction;
- acute diverticulitis;
- carcinoid.
In rare cases, a complication of bleeding from the diverticulum can be chronic. In the absence of adequate treatment, iron deficiency anemia may appear. Such a diagnosis can pose a real threat to human life. In this case, the surgeon can decide to conduct an urgent operation to remove the diverticulum.
Diagnostics
The Meckel diverticulum is one of those varieties that are problematically diagnosed with conventional means of investigation. Thus, for an accurate diagnosis, a whole range of methods is required, each of which will detect the signs of the disease and determine the degree of its danger to the person.
To begin with, the attending physician must make an anamnesis - learn about when the first signs of anxiety appeared, how intense and painful they are. It is also possible to collect an anamnesis from the patient's relatives.
In the future, an examination and a thorough physical examination are carried out. This allows you to determine the presence of muscle tension in the abdominal area, soreness, irritation.
Compulsorily conduct a laboratory study. It includes:
- a biochemical blood test;
- coprogram.
The following diagnostic measures are also shown:
- Ultrasound of the abdominal cavity - reveals the presence of the inflammatory process and the method of localization of the diverticulum.
- scintigraphy - helps to detect the mucous membrane of the ectopic type.
- colonoscopy - allows you to exclude the presence of other diseases that can cause internal bleeding.
- radiography - helps to eliminate the presence of intestinal obstruction.
- CT of the abdominal cavity - provides a clear picture of the condition of internal organs.
If you suspect a diverticulum of Meckel, you must definitely exclude a number of possible diagnoses - acute appendicitis, polyposis, duodenal ulcer.
Treatment of protrusion
The opinions of specialists regarding the treatment of Meckel's diverticulum are quite contradictory. In most cases, many doctors are of the opinion that protrusion, which does not bother the patient, should not be treated.
As for patients who suffer from the appearance of painful symptoms, surgical intervention may be necessary here.
Treatment of diverticulum in children involves a conservative approach and a gentle technique. It includes the use of antibiotic infusions, injections of anti-inflammatory drugs. If the disease does not progress, then there is no need to carry out the operation.
Operation
The operation with Meckel's diverticulum involves the removal of the formation and the resumption of normal bowel function. In the event that the intestine is affected by the appearance of protrusion, then some part of the affected organ is also removed.
If a patient is found to have serious blood loss, which is due to protrusion, the doctor can prescribe an urgent blood transfusion in order to achieve the resumption of normal volume.
Diverticulum removal surgery refers to low-risk procedures. However, the possibility of occurrence of some complications still exists.
So, after surgery, scar tissue can form. This in turn leads to blockage of the intestine. This complication carries a considerable threat to the life of the patient. Thus, in such cases the patient needs to re-operate to prevent tragic consequences.
Laparoscopic removal of Meckel's diverticulum in children:
Diet
After the operation to remove the diverticulum, all patients are shown a diet. It allows you to achieve a speedy recovery and restore the habitual work of the digestive tract.
Also dietary nutrition prevents the appearance of diarrhea and constipation, which adversely affects the process of tissue regeneration.
The diet should include:
- porridge;
- soups;
- dried fruits;
- compotes;
- vegetables and fruits;
- dietary meat and fish varieties;
- sweet berries;
- beans;
- herbs from herbs;
- herbal teas.
It is necessary to exclude any use of alcoholic products, coffee and strong tea. It is unacceptable to resort to significant physical exertion. Any neurogenic factors should also be excluded.
Forecast
In almost 95% of cases, Meckel's diverticulum does not affect the way of life of a person, which allows not resorting to surgical treatment. The presence of protrusion does not affect the digestive system and the state of other organs.