Meckel's Diverticulum

What is Meckel's diverticulum?

Meckel's diverticulum is a small pouch in the wall of the intestine, near the junction of the small and large intestines. The pouch is a remnant of tissue from the prenatal development of the digestive system. It is not made of the same type of tissue as the small intestine, but, instead, is made of the type of tissue found in the stomach or the pancreas.
 
The tissue in Meckel's diverticulum produces acid, just as the tissue of the stomach does. The intestinal lining is not accustomed to acid and thus, an ulcer can form over time. The ulcer can rupture, causing waste products from the intestine to leak into the abdominal cavity. A serious abdominal infection called peritonitis can result. The intestine can also become blocked by Meckel's diverticulum, which can prevent the passage of digested food and lead to intestinal obstruction.

How often does Meckel's diverticulum occur?

Meckel's diverticulum is the most common birth defect of the digestive system. It is present in about 2 percent of all infants. Most people with Meckel's diverticulum will never have any symptoms or problems.

Who is at risk for Meckel's diverticulum?

One to three percent of all infants have symptoms of Meckel's diverticulum. The peak age for symptoms to occur is 2 years old. Children over age 10 rarely have symptoms of Meckel's diverticulum.
 
Boys develop symptoms of Meckel's diverticulum three times more often than girls.

Why is Meckel's diverticulum of concern?

When the intestine develops an ulcer, significant bleeding can result, causing anemia (low numbers of red blood cells in the bloodstream). If enough blood is lost, a child may go into shock, which is a life-threatening situation. Further, a serious infection can occur if the intestine ruptures and leaks waste products into the abdominal cavity.

What are the symptoms of Meckel's diverticulum?

The symptom seen most often with Meckel's diverticulum is the passage of a large amount of dark red blood from the rectum. There may also be brick-colored, jelly-like stool present. Passing the blood is usually painless, although some children experience abdominal pain.
 
If your child passes blood or a bloody stool from the rectum, you should contact your child's physician as soon as possible. (Bloody stools can be a symptom of other conditions such as milk protein or food allergy, infections, polyps or rectal fissues as well, which are generally not as serious as bleeding from Meckel's diverticulum.)
 
Symptoms of Meckel's diverticulum may resemble other conditions or medical problems. Please consult your child's physician for a diagnosis.

How is Meckel's diverticulum diagnosed?

In addition to a complete medical history and physical examination, imaging tests may be done to evaluate the intestinal tract. Diagnostic procedures for Meckel's diverticulum may include the following:

• blood test - to check for anemia or infection. A stool sample may be checked for frank (obvious) or occult (hidden) blood.
  
  
• barium enema and small bowel series - a procedure performed to examine the large intestine for abnormalities. A fluid called barium (a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an x-ray) is given into the rectum as an enema. An x-ray of the abdomen shows strictures (narrowed areas), obstructions (blockages), and other problems.
  
  
• Meckel's scan - a substance called technetium is injected into your child's bloodstream though an intravenous (IV) line. The technetium can be seen on x-ray in areas of the body where stomach tissue exists, such as the Meckel's diverticulum.
  
  
• rectosigmoidoscopy - a small, flexible tube with a camera on the end is inserted into your child's rectum and sigmoid colon (last part of the large intestine). The inside of the rectum and large intestine are evaluated for bleeding, blockage, and other problems.

Treatment for Meckel's diverticulum:

Specific treatment for Meckel's diverticulum will be determined by your child's physician based on the following:

• the extent of the problem
• your child's age, overall health, and medical history
• your child's tolerance for specific medications, procedures, or therapies
• expectations for the course of the problem
• the opinion of the physicians involved in the child's care
• your opinion and preference

Physicians will usually recommend that a Meckel's diverticulum that is causing symptoms (such as bleeding) be removed with an operation. Under general anesthesia, an incision will be made in the abdomen and the abnormal tissue will be removed. Stitches and/or a special tape called steri-strips will be used to close the incision when the operation is completed.
 
Your child's physician or nurse will give you instructions to follow regarding your child's diet, pain medications, bathing, and activity at home.

Will a child with Meckel's diverticulum have problems in the future?

There are usually no long-term problems after Meckel's diverticulum is repaired.

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