Meckel's 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.
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.
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.
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.
The small intestine is the longest portion of the digestive tract. It runs from the stomach to the colon.
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
- Hemoglobin
- Stool smear for invisible blood (stool occult blood test)
- CT scan
- Technetium scan (also called a Meckel scan)
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
- Peritonitis
- 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.
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.
Version Info
Last reviewed on: 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.
