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Meckel diverticulum

A Meckel diverticulum is a pouch on the wall of the lower part of the small intestine that is present at birth (congenital). The diverticulum may contain tissue similar to that of the stomach or pancreas.

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Causes

A Meckel diverticulum is tissue left over from when a baby's digestive tract was forming before birth. A small number of people have a Meckel diverticulum. However, only a few develop symptoms.

Symptoms

Symptoms may include:

Pain in the abdomen that can be mild or severe
Blood in the stool
Nausea and vomiting

Symptoms often occur during the first few years of life. However, they may not start until adulthood.

Exams and Tests

You may have the following tests:

Hematocrit
Hematocrit
Hematocrit is a blood test that measures how much of a person's blood is made up of red blood cells as opposed to plasma. This measurement depends o...
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Hemoglobin
Hemoglobin
Hemoglobin is a protein in red blood cells that carries oxygen. The hemoglobin test measures how much hemoglobin is in your blood.
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Stool smear for invisible blood (stool occult blood test)
Stool occult blood test
The stool guaiac test looks for hidden (occult) blood in a stool sample. It can find blood even if you cannot see it yourself. It is a common type ...
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CT scan
Technetium scan (also called a Meckel scan)
Technetium scan
A liver scan uses a radioactive material to check how well the liver or spleen is working and to assess masses in the liver.
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Treatment

You may need surgery to remove the diverticulum if bleeding develops. The segment of small intestine that contains the diverticulum is taken out. The ends of the intestine are sewn back together.

You may need to take iron supplements to treat anemia. You may need a blood transfusion if you have a lot of bleeding,

Outlook (Prognosis)

Most people recover fully from surgery and will not have the problem come back. Complications from the surgery are also unlikely.

Possible Complications

Complications may include:

Excess bleeding (hemorrhage) from the diverticulum
Folding of the intestines (intussusception), a type of blockage
Intussusception
Intussusception is the sliding of one part of the intestine into another. This article focuses on intussusception in children.
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Peritonitis
Peritonitis
Peritonitis is an inflammation (irritation) of the peritoneum. This is the thin tissue that lines the inner wall of the abdomen and covers most of t...
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Tear (perforation) of the bowel at the diverticulum

When to Contact a Medical Professional

See your health care provider right away if your child passes blood or bloody stool or has ongoing abdominal pain.

Open References

References

Bass LM, Wershil BK. Anatomy, histology, embryology, and developmental anomalies of the small and large intestine. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 98.

Kleigman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Intestinal duplications, Meckel diverticulum, and other remnants of the omphalomesenteric duct. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 357.

Meckel diverticulum - illustration

Meckel diverticulum is one of the most common congenital abnormalities. It occurs when the connection between the intestine and the umbilical cord doesn't completely close off during fetal development. This results in a small outpouching of the small intestine, know as a Meckel diverticulum. In most cases, Meckel diverticula do not cause any problems. In a small number of patients however, these diverticula can become infected (diverticulitis) cause an obstruction of the intestine, or cause bleeding from the intestine. The most common symptom of Meckel diverticulitis is painless bleeding from the rectum. The stools may contain fresh blood or may look black and tarry.

Meckel diverticulum

illustration
Digestive system - illustration

The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

Digestive system

illustration
Digestive system organs - illustration

The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.

Digestive system organs

illustration
Meckel's diverticulectomy - normal anatomy

Presentation

<strong>Meckel's diverticulectomy - normal anatomy</strong><p>The small intestine is the longest portion of the digestive tract. It runs from the stomach to the colon.</p>

<strong>Indications</strong><p>Meckel's diverticulum is one of the most common congenital abnormalities. It occurs when the connection between the intestine and the umbilical cord doesn't completely close off during fetal development. This results in a small outpouching of the small intestine, know as a Meckel's diverticulum. In most cases, Meckel's diverticula do not cause any problems. In a small number of patients however, these diverticula can become infected (diverticulitis) cause an obstruction of the intestine, or cause bleeding from the intestine. The most common symptom of Meckel's diverticulitis is painless bleeding from the rectum. The stools may contain fresh blood or may look black and tarry. Diverticulitis, or infection, of a Meckel's diverticulum is often mistaken for appendicitis.</p>

<strong>Incision</strong><p>Treatment of a Meckel's diverticulum involves resection of the involved portion of the small intestine. Often, symptoms from a Meckel's diverticulum are thought to be due to appendicitis and the Meckel's diverticulum is discovered only after the operation has begun. While the patient is deep asleep and pain-free (general anesthesia), an incision is made in the right side of the lower abdomen.</p>

<strong>Procedure</strong><p>The small intestine is found and the Meckel's diverticulum is removed. The intestine is repaired and the incision is closed.</p>

<strong>Aftercare</strong><p>Intravenous fluids will be given until the patient is able to eat by mouth (after bowel sounds are heard). A nasogastric tube may be in place to empty the stomach. Antibiotics may be given to prevent or treat infection. Discharge from the hospital can be expected within a week after surgery, barring complications.</p>

Meckel diverticulum - illustration

Meckel diverticulum is one of the most common congenital abnormalities. It occurs when the connection between the intestine and the umbilical cord doesn't completely close off during fetal development. This results in a small outpouching of the small intestine, know as a Meckel diverticulum. In most cases, Meckel diverticula do not cause any problems. In a small number of patients however, these diverticula can become infected (diverticulitis) cause an obstruction of the intestine, or cause bleeding from the intestine. The most common symptom of Meckel diverticulitis is painless bleeding from the rectum. The stools may contain fresh blood or may look black and tarry.

Meckel diverticulum

illustration
Digestive system - illustration

The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

Digestive system

illustration
Digestive system organs - illustration

The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.

Digestive system organs

illustration
Meckel's diverticulectomy - normal anatomy

Presentation

Review Date: 11/2/2022

Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Meckel diverticulum

Causes

Symptoms

Exams and Tests

Hematocrit

Hemoglobin

Stool occult blood test

Technetium scan

Treatment

Outlook (Prognosis)

Possible Complications

Intussusception

Peritonitis

When to Contact a Medical Professional

References

Meckel diverticulum - illustration

Meckel diverticulum

Digestive system - illustration

Digestive system

Digestive system organs - illustration

Digestive system organs

Meckel's diverticulectomy - normal anatomy

Meckel diverticulum - illustration

Meckel diverticulum

Digestive system - illustration

Digestive system

Digestive system organs - illustration

Digestive system organs

Meckel's diverticulectomy - normal anatomy

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