SciELO - Scientific Electronic Library Online

 
vol.100 issue7Surviving in the public sectorMercury exposure in a low-income community in South Africa author indexsubject indexarticles search
Home Pagealphabetic serial listing  

SAMJ: South African Medical Journal

Print version ISSN 0256-9574

SAMJ, S. Afr. med. j. vol.100 no.7 Cape Town July 2010

 

CORRESPONDENCE

 

Meckel's diverticulitis revisited

 

 

To the Editor: Meckel's diverticulum, a true congenital diverticulum, is a small bulge in the intestine present from birth. It is a vestigial remnant of the original yolk sac or vitello-intestinal duct1 and was originally described by Johann F Meckel in 1809.2,3

I present a case of Meckel's diverticulitis in a 4-year-old boy who presented with overt iron deficiency anaemia. Ferritin levels were low and the peripheral blood showed a hypochromic, microcytic anaemia consistent with an iron-deficient picture. The haemoglobin concentration was 10 g/dl. He had a bright red melaena stool and right iliac abdominal pain. A barium meal showed Meckel's diverticulitis. The Meckel's diverticulum and adjacent ileum were successfully removed surgically.

Meckel's diverticulum is found in 2% of the population, more frequently in males; it is usually 2 foot from the ileocaecal valve and 2 inches in length (the rule of the 2s). The diverticulum usually contains oxyntic cells from gastric mucosa that cause an ulcer giving rise to intestinal bleeding. The diverticulum may contain pancreatic tissue and may obstruct or strangulate in a type of volvulus.

This patient presented with iron deficiency anaemia, but Meckel's diverticulitis can often simulate acute appendicitis. It is generally not necessary to remove Meckel's diverticula found incidentally during surgery for other reasons.4

Hilary Denis Solomons
PO Box 64203
Highlands North
Johannesburg
2037
hillysol@netactive.co.za

 

 

1. Elsayes KM, Menias CO, Harvin HJ, et al. Radiological features of Meckel's diverticulum. AJR Am J Roentgenol 2007; 189: 81-88.         [ Links ]

2. Meckel JF. Über die Divertikel am Darmkanal. Archiv für die Physiologie 1809; 9: 421-453.         [ Links ]

3. Tiu A, Lee D. An unusual manifestation of Meckel's diverticulum; strangulated paraumbilical hernia. N Z Med J 2006; 119(1236): U2034.         [ Links ]

4. Martin JP, Connor PD, Charles K. Meckel's diverticulum and its complications. Am Fam Physician 2000; 61(4): 1037-1042, 1044.         [ Links ]