Meckel's diverticulum

• 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.

Review Date: 10/13/2008

Reviewed 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.