Meckel

Meckel is a surname associated with several anatomical eponyms, the most widely known being Meckel's diverticulum. The condition is named after Johann Friedrich Meckel the Younger, a German anatomist who described it in the early 19th century. Meckel’s diverticulum refers to a true diverticulum of the ileum, representing a persistent remnant of the omphalomesenteric (vitelline) duct.

Embryology and anatomy

Meckel's diverticulum is a pouch that arises from the distal ileum. It is located on the antimesenteric border, typically about 60 centimeters (roughly 2 feet) from the ileocecal valve. It is often cited in the “rule of 2’s”: about 2% of the population, commonly 2 inches (5 centimeters) long, located about 2 feet from the valve, and presents in patients around age 2 (though symptoms can occur at any age). It is a true diverticulum, containing all layers of the intestinal wall, and may contain ectopic tissue such as gastric or pancreatic mucosa.

Clinical features and diagnosis

Most people with Meckel's diverticulum are asymptomatic. When symptomatic, common presentations include painless lower gastrointestinal bleeding due to ulceration from ectopic gastric mucosa, intestinal obstruction from intussusception or volvulus, or inflammation resembling appendicitis. Diagnosis can be aided by the technetium-99m pertechnetate scan (Meckel scan), which detects ectopic gastric mucosa, alongside other imaging modalities and clinical assessment.

Management

Asymptomatic diverticula in adults are often managed conservatively, whereas symptomatic cases typically require surgical resection, either segmental ileal resection or diverticulectomy. The decision depends on patient age, symptoms, and intraoperative findings.

Other uses

The name Meckel also appears in other anatomical terms, such as Meckel's cartilage, an embryologic structure from the first pharyngeal arch that contributes to jaw formation, illustrating the historical breadth of Meckel’s influence in anatomy.