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Meckel's Diverticulum

more about Meckel's Diverticulum


  • The Meckel's diverticulum is a small outpouching, or cul de sac of tissue, that pushes out from the wall of the lower (distal) small intestine, protruding as a side-passageway or side-piece, away from the bowel lumen.  The pouch is a congenital abnormality of the ileum that is present in about 2% of the population.  The ileum is the lowermost section of the 3 sections of small intestine, and receives the bowel contents that have passed through the duodenum and the jejunum (the other 2 sections).
  • About 1 in 50 people has a Meckel's, almost always located in the distal small intestine, within 2 feet of the junction of small intestine with the colon.  Usually in the right lower quadrant of the abdomen (RLQ), it can become inflamed, ulcerate, perforate, or cause obstruction.  If it is inflamed or perforates, it is removed by surgery.
  • The intestine obtains its blood supply and its supply of nerves (innervation) from a sheet of tissue that lies alongside, called the mesentery.  The Meckel's diverticulum protrudes from the side opposite the attachment of the mesentery.

  • In most people, it is totally asymptomatic.
  • Painless or painful rectal bleeding may occur.
  • Usually, the presenting symptom is bleeding, because the tissue inside the diverticulum may contain gastric mucosa (like the tissue lining of the stomach), which makes hydrochloric acid (Hcl).  This Hcl irritates the surrounding small intestinal tissue in the ileum, producing bleeding. In the stomach, specialized stomach glands secrete a large amount of mucus, normally preventing the stomach from bleeding.  The ileum lacks this protection.
  • Obstruction of the small intestine can also occur (small bowel obstruction=SBO) by 2 mechanisms.  If the diverticulum becomes tangled in neighboring loops of small intestine, it can cause a volvulus; or the diverticulum might invert, protruding into the ileal lumen, causing an Intussusception (telescoping of one loop of bowel into another).  The Meckel's might be discovered when a barium study or CAT scan of the small intestine is performed.
  • The pain, when it occurs, is usually in the RLQ and therefore resembles appendicitis.

  • Unknown

  • The technetium 99m scan uses a radioactive substance injected intravenously, that attaches to the bleeding gastric mucosa inside the diverticulum, and pinpoints the location of the bleeding diverticulum (usually RLQ of the abdomen).  This scanning only produces a result in an actively bleeding patient.

  • Unknown

  • Surgical removal of the diverticulum

  • Hemorrhage
  • Bowel perforation or obstruction
  • Infection

  • Physician evaluation of these symptoms is needed.
  • Volvulus, Intussusception, and the above complications can lead to more serious conditions, so do not hesitate to seek medical attention if you suspect this problem in your child.

  • Appendicitis
  • Small bowel obstruction (SBO) from other causes
  • Other causes of intestinal bleeding or intestinal hemorrhage

more about Meckel's Diverticulum

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