Meckel's diverticulum

Definition

A Meckel's diverticulum is a common congenital (present from before birth) pouch on the wall of the small bowel. The diverticulum may contain stomach or pancreatic tissue.

Causes, incidence, and risk factors

A Meckel's diverticulum is a remnant of structures within the fetal digestive tract that were not fully reabsorbed before birth. Approximately 2% of the population has a Meckel's diverticulum, but only a few develop symptoms.

Symptoms include diverticulitis or bleeding in the intestine (see GI bleeding). Symptoms often occur during the first few years of life but may occur in adults as well.

Symptoms

• Passing of blood in the stool
• Abdominal discomfort or pain ranging from mild to severe

Signs and tests

• Visible blood in stool
• Occult (invisible) blood in the stool on multiple tests
• Iron deficiency anemia

Tests:

• Stool smear for occult blood (stool guaiac)
• Hematocrit
• Hemoglobin
• Technetium scan to demonstrate diverticulum

Treatment

Surgery to remove the diverticulum is recommended if bleeding develops. In rare cases, the segment of small intestine which contains the diverticulum is surgically removed, and the ends of intestine sewn back together. Iron replacement may be needed to correct anemia. If bleeding is significant, blood transfusion may be necessary.

Expectations (prognosis)

Full recovery can be expected with surgery.

Complications

• Hemorrhage
• Perforation of the bowel at the diverticulum
• Peritonitis
• Intussusception with resultant obstruction

Calling your health care provider

See your health care provider promptly if your child passes blood or bloody stool or complains repeatedly of abdominal discomfort.