Article Sections

Introduction

Meckel diverticulum is a congenital anomaly that results from incomplete obliteration of the vitelline duct during embryonic development, creating a diverticulum in the small intestine.  It is the most common congenital anomaly of the gastrointestinal tract and follows the "rule of 2s."

Pathophysiology and risk factors

By 4 weeks gestation, the omphalomesenteric (vitelline) duct connects the yolk sac to the midgut, allowing nutrients to pass from the yolk sac to the developing embryo ( Figure 1).  Normally, the vitelline duct closes between 5 and 6 weeks gestation.  Incomplete obliteration of the vitelline duct leads to a spectrum of anomalies ( Figure 2), including:

  • Meckel diverticulum (most common) results from partial closure of the vitelline duct, with the patent portion attached to the ileum.  A fibrous band may connect the tip of the diverticulum with the umbilicus.

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