What Is It?
Meckel's diverticulum is a small pouch in the wall of the lower small intestine. The pouch is a congenital (present at birth) abnormality that affects approximately 2% of the population. The pouch, or diverticulum, seems to be leftover tissue from the development of the digestive system. This tissue normally is reabsorbed before birth. When it contains gastric (stomach) tissue, it is more likely to cause bleeding.
Most people with Meckel's diverticulum do not experience any symptoms. Symptoms occur only if the diverticulum bleeds, becomes infected or causes an obstruction. These symptoms generally occur during the first few years of life, although they may not appear until adulthood. The bleeding, even when severe, is usually painless. An infection and blockage can cause mild to severe abdominal pain and discomfort. Signs and symptoms may include:
Passage of blood with or without stools
Blood in stools, either visible or detectable only with a test
Mild to severe abdominal pain
Iron deficiency anemia and its accompanying symptoms (paleness and fatigue)
A Meckel's diverticulum can be difficult to diagnose because it does not show up on standard tests for intestinal bleeding or blockages. Its symptoms can mimic those of other conditions, such as appendicitis or gallbladder disease. One of the best ways to confirm the presence of a Meckel's diverticulum is through a special nuclear medicine scan in which a small dose of radioactive dye is injected into the bloodstream. The dye collects in stomach tissue, so a diverticulum shows up on the scan if stomach tissue is present. X-rays usually show if the intestine is blocked. However, X-rays usually cannot identify Meckel's diverticulum as the cause.
A Meckel's diverticulum remains for a lifetime unless it is removed surgically.
There is no way to prevent a Meckel's diverticulum from forming during fetal development.
Most people with a Meckel's diverticulum do not even know they have it, and no treatment is required. When problems occur, treatment depends on their type and severity. Infections are treated with antibiotics. Blood transfusions may be needed for extensive bleeding. Iron replacement may be required to correct anemia. Bowel rest, in which the patient is not allowed to eat, drink or take pills, and receives nutrition and fluids intravenously (through a vein), is sometimes needed when there is a blockage. Ultimately, a diverticulum causing problems may need to be removed surgically.
When To Call a Professional
Seek prompt medical attention if you have any of the symptoms of a problematic Meckel's diverticulum, such as passage of blood from the rectum or bloody stools. If you have abdominal pain or dizziness, you should call your doctor to determine if you need an evaluation right away.
With surgery, full recovery can be expected.
American Academy of Family Physicians (AAFP) 11400 Tomahawk Creek Parkway Leawood, KS 66211-2672 Phone: 913-906-6000 Toll-Free: 1-800-274-2237 www.familydoctor.org/
National Library of Medicine (NLM) 8600 Rockville Pike Building 38 Bethesda, MD 20894 Toll-Free: 1-888-346-3656 www.nlm.nih.gov/