Meckel’s diverticulum: Causes, Symptoms, Diagnosis and Treatment

This anomaly is of birth and usually presents gastric tissue or the pancreas, a tissue different from the one that is formed in the intestine.

Meckel’s diverticulum is an intussusception or an appendage that occurs in the lower part of the small intestine, approximately 60 to 100 cm from the ileocecal valve in the ileum or end of the small intestine. It can cause bleeding or intestinal obstructions.

Diverticula may develop with age, but when diverticulum in the intestines is present at birth, a genetic problem is called a Meckel’s diverticulum.

This develops between the fifth and seventh week of fetal development.

Causes

In the embryonic development the primitive gut presents a connection with the yolk sac that is located outside the embryo.

In the stage of fetal development the ileum is attached to the navel. This conduit that communicates them is called the omphalomesenteric conduit .

Between the 7th and 8th week of gestation, if this union between the navel and the ileum does not close properly, Meckel’s diverticulum appears, as a remainder of this canal.

symptom

Meckel’s diverticulum is asymptomatic in the vast majority of individuals who present it, but in case of presenting symptoms they appear in the first years of life. The symptoms of Meckel’s diverticulum depend on the type of diverticulum he has.

When the developing diverticulum is composed of intestinal cells, it functions as a normal part of the intestine and rarely causes significant symptoms.

But when, the diverticulum is formed by stomach or pancreatic cells, the diverticulum works differently to the intestines and can cause significant symptoms such as:

  • Abdominal pain.
  • Vomiting
  • Irritability.
  • Palpable mass on the right side of the abdomen caused by the occurrence of an intussusception, which usually occurs in children under six years of age.
  • Bleeding in the intestines, which is detected by the presence of bleeding in the stool without the presence of abdominal pain, this situation can be so abundant that it can produce a hemorrhagic shock.
  • Acute abdominal pain, located in the central or right part of the abdomen, which, due to its intensity or location, may be clinically distinguishable from acute appendicitis.

The presence of this diverticulum can generate associated complications such as:

  • Intussusception (Slipping of one part of the intestine into another, causing severe intestinal obstruction).
  • Diverticulitis (inflammation and infection of the diverticulum).
  • Hemorrhages
  • Gut perforation.

The symptoms are also related to the age at the time of Meckel’s diverticulum. Babies are more likely to have a blockage in the intestines. An intestinal hemorrhage and the presence of bloody stools are more common symptoms in older children.

Meckel diverticulum cases are diagnosed and treated in children before 10 years of age.

Diagnosis

Several tests are recommended to confirm the diagnosis:

  • Blood test: What is done to determine if the number of red blood cells is low, this will show if bleeding is occurring in the intestines.
  • Stool smear: This test is done with a stool sample to check if it contains blood.
  • Technetium scanner: This test uses a marker or contrast that will accumulate around the diverticulum to confirm the presence of Meckel’s diverticulum.
  • Colonoscopy or upper gastrointestinal endoscopy: Through this test the diverticulum can be visualized from inside the intestine.

The diagnosis of Meckel’s diverticulum indicates the degree of severity of the lesion according to the clinical pictures presented by the patient, and accordingly, decide whether a surgical intervention is necessary or not.

Treatment

In cases of excessive blood loss, iron therapy or blood transfusions are recommended as a result of Meckel’s diverticulum.

In extreme cases, emergency surgery is necessary to remove the diverticulum.

Surgery, in the case of damage to the intestines as a result of the diverticulum, involves removal of the diverticulum and repair of the intestines.

This surgery to correct Meckel’s diverticulum usually presents a low risk of complications.

But some complications may arise after surgery, such as a development of scar tissue, which could cause a blockage in the intestines, which can be deadly and require a new intervention to eliminate the blockage.