[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Embryology](https://durgical.com/en/embryology/) › [Digestive system](https://durgical.com/en/embryology/#a-digestive) › Meckel diverticulum and other vitelline duct remnants [Embryology](https://durgical.com/en/embryology/) · [Digestive system](https://durgical.com/en/embryology/#a-digestive) # 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 **See it in 3D:** [Ileum](https://durgical.com/en/anatomy/ileum/) · [Cecum](https://durgical.com/en/anatomy/cecum/) ## Key points - Persistent vitelline duct: a true diverticulum on the antimesenteric border of the distal ileum, not far from the ileocecal valve. - The most common congenital gut anomaly: about 2 % of people, most without symptoms; twice as common in males. - Most common complication in children: painless rectal bleeding from ectopic gastric mucosa that ulcerates the nearby ileum. - Others: obstruction by intussusception or volvulus, diverticulitis that mimics appendicitis, and perforation. - Diagnosis: technetium-99m scan, taken up by ectopic gastric mucosa. - Other remnants: vitelline fistula (bowel content at the umbilicus), vitelline cyst and a fibrous band from ileum to umbilicus. ## 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. ## Memory aid The ileum kept a souvenir of the yolk sac: a pouch that sometimes packs a piece of stomach, and its acid makes the neighbour bleed without the warning of pain. ## 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. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/embryology/meckel-diverticulum-and-other-vitelline-duct-remnants/) ## See it in 3D The structures of Durgical's 3D anatomy where it is found. - [Ileum](https://durgical.com/en/anatomy/ileum/) - [Cecum](https://durgical.com/en/anatomy/cecum/) ## Related - [Midgut: physiological herniation and rotation](https://durgical.com/en/embryology/midgut-physiological-herniation-and-rotation/) - [Primitive gut: foregut, midgut and hindgut and their arteries](https://durgical.com/en/embryology/primitive-gut-foregut-midgut-and-hindgut-and-their-arteries/) - [Malrotation and midgut volvulus](https://durgical.com/en/embryology/malrotation-and-midgut-volvulus/) - [Umbilical cord: two arteries, one vein](https://durgical.com/en/embryology/umbilical-cord-two-arteries-one-vein/) - [Urachal anomalies: patent urachus, cyst and sinus](https://durgical.com/en/embryology/urachal-anomalies-patent-urachus-cyst-and-sinus/) - [Annular pancreas and pancreas divisum](https://durgical.com/en/embryology/annular-pancreas-and-pancreas-divisum/) ## Related conditions - [Lower gastrointestinal bleeding](https://durgical.com/en/conditions/lower-gastrointestinal-bleeding/) - [Intussusception (children)](https://durgical.com/en/conditions/intussusception/) - [Acute appendicitis](https://durgical.com/en/conditions/acute-appendicitis/) [← All of embryology](https://durgical.com/en/embryology/) 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](https://www.ncbi.nlm.nih.gov/books/NBK499960/) (StatPearls Publishing (NCBI Bookshelf), 2023); [Embryology, Midgut](https://www.ncbi.nlm.nih.gov/books/NBK553156/) (StatPearls Publishing (NCBI Bookshelf), 2023); [Meckel diverticulum](https://medlineplus.gov/ency/article/000234.htm) (MedlinePlus, U.S. National Library of Medicine, 2024). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/embryology/meckel-diverticulum-and-other-vitelline-duct-remnants/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/embryology/meckel-diverticulum-and-other-vitelline-duct-remnants/