Meckel diverticulum and other vitelline duct remnants !
- Malformation
A leftover of the duct that joined the gut to the yolk sac remains as a small pouch on the ileum; it can bleed without pain.
Updated 2026-11-01
What it is
Meckel diverticulum is persistence of the intestinal end of the vitelline (omphalomesenteric) duct, which normally closes in the embryonic period. It is a true diverticulum of the ileum, containing every layer of the wall, and the most common congenital anomaly of the gut. It may carry ectopic gastric or pancreatic mucosa, the cause of painless bleeding in young children.
Embryological cause
- In the embryo the vitelline duct joins the apex of the midgut loop to the yolk sac.
- Normally it narrows, closes and disappears.
- If its intestinal end persists, a Meckel diverticulum remains, which may contain ectopic gastric or pancreatic mucosa.
- If it persists along its whole length, a fistula joins the ileum and umbilicus; if only parts persist, a vitelline cyst or a fibrous band remains.
How it presents
- Painless rectal bleeding, sometimes heavy, in young children.
- Bowel obstruction by intussusception (the diverticulum as lead point) or by volvulus around a fibrous band.
- Diverticulitis with right iliac fossa pain that is confused with appendicitis.
- Vitelline fistula: bowel content or meconium leaking at the umbilicus.
- Many are found by chance at surgery or on imaging.
Diagnosis
- Technetium-99m scan (Meckel scan): detects ectopic gastric mucosa.
- CT or ultrasound for complications such as intussusception or diverticulitis.
- With a fistula, contrast through the umbilical opening shows the connection to the ileum.
Test yourself
Think of the answer, then tap the question to see it.
Which embryonic structure does Meckel diverticulum come from?
The vitelline or omphalomesenteric duct, which joined the midgut to the yolk sac.
Why can it bleed without pain?
Because it may contain ectopic gastric mucosa that secretes acid and ulcerates the nearby ileal mucosa.
Which nuclear medicine test detects it?
The technetium-99m scan, which is taken up by ectopic gastric mucosa.
Which vitelline remnant leaks bowel content at the umbilicus?
A vitelline (omphalomesenteric) fistula, when the duct persists along its whole length between ileum and umbilicus.
See it in 3D
The structures of Durgical's 3D anatomy where it is found.
Related
- Midgut: physiological herniation and rotation
- Primitive gut: foregut, midgut and hindgut and their arteries
- Malrotation and midgut volvulus
- Umbilical cord: two arteries, one vein
- Urachal anomalies: patent urachus, cyst and sinus
- Annular pancreas and pancreas divisum
Related conditions
Educational content on embryonic development; not a guide to prenatal diagnosis or to medicines in pregnancy and no substitute for a health professional's advice. No doses are given.
Sources: Meckel Diverticulum (StatPearls Publishing (NCBI Bookshelf), 2023); Embryology, Midgut (StatPearls Publishing (NCBI Bookshelf), 2023); Meckel diverticulum (MedlinePlus, U.S. National Library of Medicine, 2024).
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Representative model, for educational purposes only.