• Meckels Diverticulum

    Definition

    Meckels 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, Meckels diverticulum doesn't cause problems or require treatment. One serious complication, called Meckels diverticulitis, is an infection and inflammation of the pouch. Meckels diverticulitis requires prompt medical attention.
    Meckels Diverticulum
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    Causes

    Meckels 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 Meckels 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

    Meckels 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 Meckels diverticulum don't have symptoms.
    Meckels diverticulum that is infected or inflamed can cause:
    • Blood in the stool
    • Cramping abdominal pain
    • Vomiting
    • Fever
    • Constipation
    Meckels 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 Meckels diverticulum based on your symptoms, but it can be difficult to diagnose, especially in adults.
    Meckels 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 Meckels 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 Meckels 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 Meckels 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.

    Prevention

    There are no current guidelines to prevent Meckels 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, et al. Surgical management of Meckel’s diverticulum. An epidemiologic population-based study. Ann Surg. 1995; 222(40):568-569.

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

    Lin S, Suhocki PV, et al. Gastrointestinal bleeding in adult patients with Meckel’s diverticulum: The role of technetium 99m pertechnetate scan. South Med J. 2002;95(11):1338-1341.

    Martin JP, Connor PD, et al. Meckel’s diverticulum. Am Fam Physician. 2000;16(4):1037-1042..

    Meckel diverticulum. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gastrointestinal-disorders/diverticular-disease/meckel-diverticulum. Updated June 2013. Accessed August 19, 2014.

    Revision Information

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