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- Failure of yolk sac to close in fetal life
- 0.5-3% of population
- Seen on anti mesenteric border of ileum
- 30-90 cm from ileocecal valve
- Size from 0.5 to 13 cm
- 20-40% cases symptomatic
- Complications: ulceration, bleeding, perforation, inflammation, intussusception, internal hernia, volvulus, adhesions
- Ectopic gastric mucosa in 20% of adults and all children who present with bleeding
Imaging
- Pre-op diagnosis difficult
- Tc 99m radionuclide imaging more accurate in children
- Enteroclysis: blind-ending sac from anti-mesenteric border of ileum, triradiate mucosal folds seen at base of diverticulum. Diverticulum if inverted, appears like a polypoid filling defect, and can present with intussusception
- CT: role in inflamed diverticulum. Thick homogeneously enhancing walls, adjacent inflammation. Sometimes endolith is seen.
- Angiography: persistent vitelline artery is hallmark in patients with chronic GI bleed