Meckel's diverticulum
Definition
A Meckel's diverticulum is a pouch on the wall of the lower part of the small bowel that is present at birth (congenital). The diverticulum may contain tissue from the stomach or pancreas.
Causes
A Meckel's diverticulum is tissue left over from structures in the unborn baby's digestive tract that were not fully reabsorbed before birth. Approximately 2% of the population has a Meckel's diverticulum, but only a few people develop symptoms.
Symptoms
- Abdominal discomfort or pain ranging from mild to severe
- Passing of blood in the stool
Symptoms often occur during the first few years of life, but may not start until adulthood.
Exams and Tests
- Blockage of the intestine
- Inflammation of the pouch (diverticulitis)
- Invisible (occult) blood in the stool
- Painless bleeding in the intestine (see GI bleeding)
- Visible blood in the stool
Tests:
- Hematocrit
- Hemoglobin
- Stool smear for invisible blood (stool guaiac)
- Technetium scan
Treatment
Surgery to remove the diverticulum is recommended if bleeding develops. In these rare cases, the segment of small intestine that contains the diverticulum is surgically removed. The ends of the intestine are sewn back together.
You may need iron replacement to correct anemia. If you have a lot of bleeding, you may need a blood transfusion.
Outlook (Prognosis)
Full recovery can be expected with surgery.
Possible Complications
- Excess bleeding (hemorrhage)
- Folding of the intestines (intussusception), a type of blockage
- Peritonitis
- Tear (perforation) of the bowel at the diverticulum
When to Contact a Medical Professional
See your health care provider promptly if your child passes blood or bloody stool or complains repeatedly of abdominal discomfort.
References
Kahn E, Daum F. Anatomy, histology, embryology, and developmental anomalies of the small and large intestine. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2006:chap 93.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
