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Genetic

Meckel's diverticulum

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Definition

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

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
  • Blood in the stool - visible or invisible (occult)
  • Inflammation of the pouch (diverticulitis)

Tests:

  • Hematocrit
  • Hemoglobin
  • Stool smear for invisible blood (stool occult blood test )
  • 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) from the diverticulum
  • 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, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 96.

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