Meckel's diverticulum is an outpouching or bulge in
the lower part of the small intestine. The bulge is congenital (present at
birth) and is a leftover of the umbilical cord. Meckel's diverticulum is the
most common congenital defect of the gastrointestinal tract. It occurs in about
2-3 percent of the general population.
What causes Meckel's diverticulum?
Meckel's diverticulum occurs in a fetus early in the
pregnancy. Normally, the vitelline duct, which connects the growing fetus with
the yolk sac, is absorbed into the fetus by the seventh week of the pregnancy.
When the vitelline duct is not fully absorbed, a Meckel's diverticulum develops.
A Meckel's diverticulum may contain cells from both
the stomach and pancreas. Cells from the stomach can secrete acid, which can
cause ulcers and bleeding.
Who gets Meckel's diverticulum?
Though about 2-3 percent of the population get
Meckel's diverticulum, it causes symptoms in only a small number of those
people. People can live their whole lives without ever knowing they have
Meckel's diverticulum. The condition is equally common among males and females,
but males are two to three times more likely to have complications.
What are the symptoms of Meckel's diverticulum?
Symptoms of Meckel's diverticulum usually occur during
the first year of a child’s life, but can occur into adulthood.
- Gastrointestinal bleeding (which can be seen in the stool)
- Abdominal pain and cramping
- Tenderness near the navel (belly button)
- Obstruction of the bowels, a blockage that keeps the contents of the
intestines from passing. This can cause pain, bloating, diarrhea, constipation, and vomiting.
- Diverticulitis (swelling of the intestinal wall)
The most common symptom in children under five is
bleeding, which is caused by ulcers that develop in the small intestine when the
diverticulum secretes stomach acid. Bowel obstruction occurs more often in older
children and adults. Diverticulitis can occur at any age, but is most common in
older children. Tumors can occur mainly in adults; these are a rare symptom of Meckel's diverticulum.
If your child exhibits any of the above symptoms, you should see your pediatrician or health care provider immediately.
How is Meckel's diverticulum diagnosed?
Meckel's diverticulum can be difficult to diagnose.
Many of the symptoms, such as vomiting, abdominal pain, and tenderness, can
occur in several different conditions. If your child's health care provider
feels that the combination of symptoms suggests Meckel's diverticulum, he or she
will order certain tests. These include:
- Technetium scan: This test is a scan. Radioactive technetium is injected
into the body. This substance is absorbed by stomach cells in the diverticulum and can be detected by a special camera.
- Colonoscopy: In this test, a small, flexible tube with a camera on the
end is inserted into the rectum and colon to look for blockages and the cause of bleeding.
- Wireless capsule endoscopy: For this test, the patient swallows a small
camera that can detect sources of bleeding in the small intestine. If your
child is too young to swallow a pill, it can be placed in the stomach while your child is asleep.
How is Meckel's diverticulum treated?
Many adults who have Meckel's diverticulum never have
symptoms. They learn they have the condition only after it is noticed during
surgery or during tests for another condition. In this case, Meckel's
diverticulum usually does not have to be treated.
Surgery to remove the diverticulum may be recommended
if bleeding develops. During this procedure, the Meckel's diverticulum and
surrounding small intestine are removed and the ends of the remaining intestines are sewn together.
This can be done either through open abdominal surgery
or laparoscopically (a narrow tube with a camera is inserted through a small
incision, and the Meckel's diverticulum is repaired through another small
incision). Your physician can recommend the best approach based on your child’s symptoms, age, and general health.
What is the long-term prognosis (outlook) for patients who have Meckel's diverticulum?
The long-term prognosis is excellent. Patients can expect a full recovery after treatment.
Merck Manuals Online Library. Meckel's Diverticulum.
www.merck.com Accessed January 28, 2011.
Martin JP, Connor PD, Charles K. Meckel's Diverticulum. Am Fam Physician 2000;61:1037-42.
www.aafp.org. Accessed January 28, 2011.
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