Meckel's Diverticulum: An In-depth Review of Pathophysiology, Clinical Presentation, Diagnostic Modalities, and Therapeutic Interventions

Abstract

Background: Meckel's diverticulum is the most prevalent congenital anomaly of the gastrointestinal tract, resulting from the incomplete obliteration of the omphalomesenteric duct during fetal development. Although often asymptomatic, it can present with a variety of complications, including bleeding, obstruction, and inflammation, necessitating timely and accurate diagnosis and intervention.

Objective: This article aims to provide a comprehensive overview of Meckel's diverticulum, including its embryological origin, pathophysiological features, clinical manifestations, diagnostic strategies, and therapeutic approaches.

Methods: A thorough literature review was conducted, focusing on studies and case reports detailing the clinical presentation, imaging modalities, surgical techniques, and outcomes associated with Meckel's diverticulum. Key databases such as PubMed, Scopus, and Web of Science were searched for relevant articles published up to August 2024.

Results: Meckel's diverticulum typically presents in childhood but can manifest at any age. Its clinical presentation ranges from asymptomatic incidental findings to acute abdomen scenarios due to complications like hemorrhage, intestinal obstruction, diverticulitis, and, rarely, neoplastic transformation. Diagnostic imaging, including technetium-99m pertechnetate scintigraphy (Meckel's scan), CT, and MRI, plays a crucial role in the preoperative identification of the diverticulum. The management of symptomatic Meckel's diverticulum is predominantly surgical, with laparoscopic and open approaches being widely utilized. Prophylactic resection in asymptomatic cases remains controversial, with decision-making guided by patient-specific factors such as age, diverticulum characteristics, and the presence of ectopic tissue.

Conclusion: Meckel's diverticulum, though often a silent anomaly, can present with significant clinical challenges. Early recognition and appropriate management are essential for optimal patient outcomes. This review highlights the importance of a multidisciplinary approach involving pediatricians, surgeons, and radiologists in the diagnosis and treatment of this condition.