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 can produce acid, just as the tissue of the stomach does. The intestinal lining is sensitive to being in contact with acid, and eventually an ulcer can form. The ulcer can perforate (rupture), causing waste products from the intestine to leak into the abdomen. A serious abdominal infection called peritonitis can result. The intestine can also become obstructed (blocked) by Meckel's diverticulum.

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 the population.

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. A serious infection may also occur if the intestine perforates and leaks waste products into the abdomen.

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 may experience abdominal pain.

If your child passes blood or a bloody stool from the rectum, you should contact your child's doctor as soon as possible.

Symptoms of Meckel's diverticulum may resemble other conditions or medical problems. Please consult your child's doctor 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. This test checks 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 an 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.

What is the treatment for Meckel's diverticulum?

Specific treatment for Meckel's diverticulum will be determined by your child's doctor 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 health care providers involved in the child's care
• Your opinion and preference

Doctors will usually recommend that a Meckel's diverticulum that is causing symptoms (such as bleeding) be surgically removed. 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 doctor 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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