Meckel’s diverticulum is a small pouch within the intestinal wall, situated nearby the ileocecal valve (junction of the small and large intestine). It is the most common congenital gastrointestinal malformation occurring in 1 to 3 percent of general population. The pouch is left over tissue from the digestive system that is formed during the developing stage of fetus.
Although the dirverticulum is in intestine its tissues are of stomach and pancreas. Hence the Meckel’s diverticulum can secrete acid and juices similar to the tissue of stomach. The lining of intestine is sensitive to acid as a result there is risk of development of intestinal ulcer and perforation.It is the most common cause of painless, recurrent and episodic rectal bleeding in children. If the ulcer is perforated it can lead to serious life threatening peritonitis.
Meckel’s diverticulum in some people remains asymptomatic. Treatment for patients with recurrent bleeding, intestinal blockage may need surgical repair of the intestine. Prognosis is excellent after surgery.
What Causes Meckel’s Diverticulum?
A diverticulum is formation of pouch in the intestinal wall. It develops in the weak area of intestine. There are various types of diverticulum that develop according to the age. Meckel’s diverticulum is a congenital variant which develops during the early stage of intestinal development in the fetus.Normally the vittelline duct gets absorbed into the fetus by four months of pregnancy. However, if part of vittelline duct remains, it gets transformed into Meckel’s diverticulum. Vittelline duct is a connecting tube between the fetus and yolk sac.
The peculiarity of meckel’s diverticulum is that it contains cells of pancreas as well as stomach instead of intestine although the diverticulum is in intestine. The cellular tissue of stomach and pancreas can secrete acid which can corrode the wall of intestine leading to ulcers and even perforation of the wall of intestine.
Meckel’s diverticulum is common gastrointestinal anomaly and large number of people may be having this anatomical abnormality. Fortunately, not all develop symptoms. Some remain asymptomatic till lifetime. The condition is present in both genders but symptoms are predominantly seen in males.
Signs And Symptoms Of Meckel’s Diverticulum
Meckel’s diverticulum presents with wide variety of clinical symptoms. It depends on which type of diverticulum is present. If the tissues of diverticulum are similar to intestinal cells, then the function of diverticulum is same as that of intestine. However, if the cells of diverticulum are those of stomach and pancreas, this may cause problem because of acid secretion.
Meckel’s diverticulum is present since birth and the incidence of symptoms are more in children than in adults. As age advances the risk of complications becomes less. The most common symptoms of Meckel’s diverticulum are:
- Passage of large quantity of dark blood from rectum. This is more common in children as compared to adults.
- The stool is jelly like containing blood.
- Some children may complain of cramps in abdomen. In some children it is painless bleeding.
- Adults and older children mainly complain of diverticulits or inflammation of intestinal wall. This may result in abdominal pain.
- Tenderness in umbilical area.
- Obstruction of intestine which causes pain in abdomen, severe constipation, gasses, distension of abdomen, vomiting etc. Bowel obstruction mainly occurs in older children and adults.
Diagnosis And Treatment Of Meckel’s Diverticulum
Meckel’s diverticulum is often difficult to diagnose because there are many different conditions that may have pain in abdomen, vomiting, intestinal blockage, tenderness as its symptom. However, when the doctor suspects the leading symptoms to be that of Meckel’s diverticulum, he will recommend certain tests which consist of technetium scan, colonoscopy, barium enema, and rectosigmoidoscopy.
Many people who have Meckel’s diverticulum are asymptomatic and they come to know about this problem only during abdominal surgery or scan done for some other medical reason. In such situation patient having Meckel’s diverticulum does not require any specific treatment.
If there are associated complications or too much of bleeding from the rectum, surgery will be recommended by the doctor. Surgery consists of removing Meckel’s diverticulum and the nearby tissue of the small intestine. The two ends of intestine are stitched.
Person with loss of blood from rectum may develop anemia. Such patients may require supplementary iron therapy or blood transfusion depending on the hemoglobin count in blood.
Prognosis after treatment of symptomatic Meckel’s diverticulum is good.