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 produces 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 all infants. Most people
with Meckel's diverticulum will never have any symptoms or problems.
Who is at risk for Meckel's diverticulum?
One to three percent of all infants have symptoms of Meckel's
diverticulum. The peak age for symptoms to occur is 2 years old. Children
over age 10 rarely have symptoms of Meckel's diverticulum.
Boys develop symptoms of Meckel's diverticulum three times more often
than girls.
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. Further, a serious infection can 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 experience abdominal pain.
If your child passes blood or a bloody stool from the rectum, you
should contact your child's physician as soon as possible.
Symptoms of Meckel's diverticulum may resemble other conditions or
medical problems. Please consult your child's physician 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 - to check 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 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.
Treatment for Meckel's diverticulum:
Specific treatment for Meckel's diverticulum will be determined by your
child's physician 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 physicians involved in the child's care
- your opinion and preference
Physicians will usually recommend that a Meckel's diverticulum that is
causing symptoms (such as bleeding) be removed with an operation. 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 physician 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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