A congenital malformation caused by the incomplete closure of the egg yolk duct. It mostly occurs on the opposite side of the mesentery in the terminal ileum, 25–100 cm from the ileocecal region. Simple Meckel's diverticulum usually does not cause clinical symptoms, but once pathological changes occur, it can lead to inflammation, ulcers, bleeding, perforation, and intestinal obstruction, with varying clinical manifestations. Diagnosis is relatively difficult and is generally confirmed through barium contrast examination or during surgery.

bubble_chart Diagnosis

1. Lower abdominal pain is more severe in the right lower quadrant, accompanied by nausea or vomiting, with varying degrees of fever; diverticular ulcer may present with varying degrees of intestinal bleeding.

2. Tenderness, rebound tenderness, and muscle rigidity are present in the right lower abdomen near the midline; acute diffuse peritonitis signs may occur if suppuration or perforation develops.

3. Total white blood cell count and neutrophil count are increased.

4. X-ray barium contrast examination of the digestive tract can reveal diverticula.

5. Radionuclide scanning often shows the shadow of a diverticulum with ectopic gastric mucosa.

6. If acute appendicitis is diagnosed but no pathological changes are found in the appendix during surgery, the terminal 100 cm of the ileum should be routinely explored to avoid missing Meckel's diverticulum. {|105|}

bubble_chart Treatment Measures

1. For diverticula with a base diameter less than 1.0 cm, they can be managed using the appendectomy method.

2. For diverticula with a wider base that cannot be simply ligated, the diverticulum can be excised and the intestine transversely sutured, or the diverticulum along with a portion of the intestine can be removed followed by end-to-end anastomosis.