Meckel's diverticulum is the most common congenital malformation of gastrointestinal tract. It can cause complications in the form of ulceration, haemorrhage, intussusception, intestinal obstruction, perforation and, very rarely, vesicodiverticular fistulae and tumours. These complications, especially bleeding, are more common in the paediatric age group than in adults; however it is not uncommon to miss the diagnosis of Meckel's diverticulum in adults. Here, we reviewed the literature regarding the complications of this forgotten clinical entity in adults with potential diagnostic difficulties and management strategies.
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INTRODUCTION
Meckel's diverticulum is the most common congenital malformation of the gastrointestinal tract (present in 2%-4% of population) due to persistence of the congenital vitello-intestinal duct. Bleeding from Meckel's diverticulum due to ectopic gastric mucosa is the most common clinical presentation, especially in younger patients (Figure 1 in colour online), but it is rare in the adult population. The complications in adults include: obstruction; intussusception; ulceration; haemorrhage; and, rarely, vesicodiverticular fistulae and tumours. Due to the rarity of cases in adults, it is still misdiagnosed preoperatively—although with the wide spread use of technetium-99m pertechnate scan and diagnostic laparoscopic approach, the rates of preoperative diagnosis have improved. Here, we review the current literature of this forgotten clinical entity for its clinical diversity, diagnostic difficulties and management controversies.