Meckel’s Diverticulum

Definition

Meckel’s diverticulum is a pouch of extra tissue in the wall of the small intestine. It's the most common birth defect of the gastrointestinal tract.In most people, Meckel's diverticulum doesn't cause problems or require treatment. One serious complication, called Meckel's diverticulitis, is an infection and inflammation of the pouch. Meckel's diverticulitis requires prompt medical attention.
Meckel’s Diverticulum
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Causes

Meckel's diverticulum develops before birth. It is created by a section of tissue that acts as a link to the umbilical cord in early development. Normally this tissue shrinks and is reabsorbed by the 7th week of pregnancy. In Meckel's diverticulum, the tissue remains, creating a pouch or bulge in the lower part of the small intestine.It is not clear why this tissue is not reabsorbed, but it may be caused by a combination of genetic and environmental factors.

Risk Factors

Meckel's diverticulum occurs more often in males than females.Complications are also more likely to develop in male children under 2 years old.

Symptoms

Most people with Meckel's diverticulum don't have symptoms.Meckel's diverticulum that is infected or inflammed can cause:
  • Blood in the stool
  • Cramping abdominal pain
  • Vomiting
  • Fever
  • Constipation
Meckel's diverticulitis can cause sudden and severe symptoms that mimic appendicitis , such as:
  • Pain in lower abdomen that worsens with sneezing, coughing, and deep breathing
  • Loss of appetite
  • Slight fever

Diagnosis

If you have symptoms, the doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor may suspect Meckel's diverticulum based on your symptoms, but it can be difficult to diagnose, especially in adults.Meckel's diverticulum without symptoms is usually found incidentally during another procedure.It may be found with imaging tests, such as:Laparoscopy may be used in some cases when diagnosis is more difficult. If Meckel's diverticulum is found during this test, it may be removed.

Treatment

If you are experiencing complications, such as bleeding, your doctor will likely recommend surgical removal of your Meckel’s diverticulum. In many cases, the surgery can be minimally invasive. This method uses small incisions and specialized tools instead of a larger incision and open surgery.If the Meckel's diverticulum is not causing problems but has been discovered, it may be removed to prevent potential complications. Surgery will depend on your overall health and risk factors. In some, removal may not be necessary.

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Prevention

There are no current guidelines to prevent Meckel's diverticulum since the cause is unknown.

RESOURCES

Family Doctor—American Academy of Family Physicians
http://familydoctor.org

National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

CANADIAN RESOURCES

Canadian Association of Gastroenterology
http://www.cag-acg.org

North American Society for Pediatric Gastroenterology
http://www.naspghan.org

References

Cullen JJ, Kelly KA, Moir CR, et al. Surgical management of Meckel’s diverticulum. An epidemiologic population-based study. Ann Surg. 1995; 222:568-569.

Meckel diverticulum. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 19, 2012. Accessed August 19, 2014.

Meckel diverticulum. PEMSoft at EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Accessed August 19, 2014.

Lin S, Suhocki PV, Ludwig KA, et al. Gastrointestinal bleeding in adult patients with Meckel’s diverticulum: The role of technetium 99m pertechnetate scan. South Med J. 2002;95:1338-1341.

Martin JP, Connor PD, Charles K. Meckel’s diverticulum. Am Fam Physician. 2000; 16:1037-1042..

Meckel diverticulum. The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/gastrointestinal%5Fdisorders/diverticular%5Fdisease/meckel%5Fdiverticulum.html. Updated June 2013. Accessed August 19, 2014.

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