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, incidence, and risk factors

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.

Signs 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.

Expectations (prognosis)

Full recovery can be expected with surgery.

Complications

Excess bleeding (hemorrhage)
Folding of the intestines (intussusception), a type of blockage
Peritonitis
Tear (perforation) of the bowel at the diverticulum

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.

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 on October 13, 2008 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.