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Meckel’s Diverticulum

Last updated Nov. 13, 2018

Approved by: Krish Tangella MD, MBA, FCAP

NIH

CT findings of Meckel’s diverticulum. A: Abdominal CT showed an extended part in the distal ileum. Continuity between the extended part and small intestine was unknown (Case 7). B: Abdominal CT revealed a polypoid lesion in the distal ileum. The peripheral branch of the ileocolic artery entered Meckel’s diverticulum. The polypoid lesion was regarded as Meckel’s diverticulum.


What are the other Names for this Condition? (Also known as/Synonyms)

  • Diverticulum of Meckel
  • Herniation causing Meckel’s Diverticulum
  • Ileal Diverticulum

What is Meckel’s Diverticulum? (Definition/Background Information)

  • Meckel’s Diverticulum is a sac on the wall of the bottom part of the intestine that is present at birth (congenital condition). The presence of such a sac is abnormal, and it causes a structure called a diverticulum
  • The cause of Meckel’s Diverticulum is tissue left over from the baby’s digestive tract, during fetal growth and development. The condition is known to affect 2% of the global population
  • However, the condition is asymptomatic in many individuals. Hence, in many, Meckel’s Diverticulum may not be diagnosed. Some signs and symptoms of Meckel’s Diverticulum include pain in the abdomen, nausea and vomiting, or blood in the stool
  • Excess bleeding or blockages in the intestines are some of the complications of Meckel’s Diverticulum. Children and infants are at the highest risk of developing complications
  • Individuals with Meckel’s Diverticulum who experience no symptoms or complications do not need treatment. Nevertheless, severe cases may require a surgical removal of the diverticulum
  • The prognosis of Meckel’s Diverticulum is generally excellent with or without treatment. Even if a surgery is required, most individuals are able to recover fully from the condition

Who gets Meckel’s Diverticulum? (Age and Sex Distribution)

  • Meckel’s Diverticulum is seen to affect 2% of the world population. In a majority of individuals, the condition may not be diagnosed due to the absence of significant signs and symptoms
  • Meckel’s Diverticulum is a congenital condition that may manifest at birth or during adulthood
  • It affects both male and female sexes equally
  • All racial and ethnic groups are at risk

What are the Risk Factors for Meckel’s Diverticulum? (Predisposing Factors)

The risk factors for Meckel’s Diverticulum may include:

  • Crohn’s disease (inflammatory bowel disease): Individuals with Crohn’s disease may have a higher incidence of signs and symptoms due to Meckel’s Diverticulum
  • Increased occurrence of Meckel’s Diverticulum is associated with certain congenital conditions. These include:
    • Esophageal atresia, where a part of the tube connecting the mouth and stomach is missing
    • Malformations in the anus: The anus and the rectum develop abnormally 
    • Omphalocele - when the liver, bowel, and other organs remain outside the abdomen in a sac
    • Different neurological and cardiovascular conditions

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases the chance of getting a condition in comparison to an individual without any risk factors. Some risk factors are more important than others.

At the same time, not having a risk factor does not mean one will not get a condition. For more clarity, discuss with your healthcare provider the effects of risk factors.

What are the Causes of Meckel’s Diverticulum? (Etiology)

The cause of Meckel’s Diverticulum is tissue left over from the baby’s digestive tract that was formed during embryological growth and development in the womb. The left over tissue is known as the vitelline duct.

What are the Signs and Symptoms of Meckel’s Diverticulum?

1 in 50 individuals may be born with Meckel’s Diverticulum. But, not all individuals with Meckel’s Diverticulum (children and adults) have signs and symptoms. Thus, in a majority of individuals, the condition remains undiagnosed, due to the absence of any presentation. In some, the signs and symptoms may develop later, as the child moves into adulthood.

In general, one-third of the affected individuals may have the following signs and symptoms of Meckel’s Diverticulum:

  • The navel or belly button may be tender
  • Pain in the abdomen that can be mild or severe, which is an indication of Meckel’s Diverticulum
  • Blood in stool
  • Abnormal bowel movements
  • Vomiting and nausea
  • For some reason, the symptoms are 2-times more common in males than females

How is Meckel’s Diverticulum Diagnosed?

In a vast majority of individuals, Meckel’s Diverticulum often goes undiagnosed, because they have no signs and symptoms of the condition. In individuals who have signs and symptoms indicating the presence of a ‘possible’ Meckel’s Diverticulum, the following methods can be helpful in arriving at a diagnosis.

After the healthcare provider documents a thorough medical history and physical examination, the following tests may be conducted:

  • Hematocrit test to determine the percentage of red blood cells in blood
  • Hemoglobin test to measure the amount of hemoglobin in blood
  • Technetium scan (Meckel’s scan) and CT scan of the abdomen
  • Occult fecal blood test: In this test, the stool is tested for the presence of blood, which may not be invisible to the naked eye
  • A barium enema or small bowel series may be performed. In this procedure, the rectum is filled with barium fluid (enema); any abnormalities in the insides will be visible on an X-ray
  • A rectosigmoidoscopy, a tube with a camera on the end is inserted into the rectum and possible bleeding or blockages are noted (also known as a colonoscopy)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Meckel’s Diverticulum?

Children and infants are at the highest risk for complications, and for some reason, complications occur more often in males than females. Due to this, males are more frequently diagnosed with Meckel’s Diverticulum than females.

The possible complications with Meckel’s Diverticulum include:

  • A blockage in the intestines caused by folding of the intestines (intussusception)
  • Abnormal and excessive bleeding arising within the diverticulum
  • Injury to the diverticulum may result in perforation of the bowel wall
  • Inflammation of the peritoneum, which is a thin tissue that lines the inside of the abdomen
  • Rarely, tumors can occur within a Meckel’s Diverticulum. The most common tumor includes carcinoid tumors and gastrinomas. These tumors arise from abnormal collection of neuroendocrine cells or gastrin hormone producing cells

How is Meckel’s Diverticulum Treated?

Generally, individuals with Meckel’s Diverticulum presenting no signs and symptoms do not require any treatment. In others with significant signs and symptoms, the following treatment measures may be considered:

  • Iron supplements may need to be taken to treat anemia
  • A blood transfusion may be performed if bleeding is excessive
  • The diverticulum may need to be surgically removed, if there is bleeding due to the condition. A laparoscopic surgery may be conducted that involves removing the diverticulum through small holes, else an open abdominal surgery may be performed

How can Meckel’s Diverticulum be Prevented?

Currently, there are no definitive methods to prevent Meckel’s Diverticulum, which is a congenital condition.

What is the Prognosis of Meckel’s Diverticulum? (Outcomes/Resolutions)

  • The prognosis of Meckel’s Diverticulum is generally excellent with adequate treatment, because most individuals recover fully after surgery
  • A majority of the individuals with Meckel’s Diverticulum do not experience any discomfort or signs and symptoms of the condition

Additional and Relevant Useful Information for Meckel’s Diverticulum:

Technetium scan or a Meckel’s scan: The scan procedure consists of injecting into the veins, a liquid with small amounts of radioactive molecules in it, called Technetium-99m. A camera, called a gamma camera, is used to take pictures of the abdomen after the liquid has been injected. The test will indicate the presence of rectal bleeding, one of the signs of Meckel’s Diverticulum.

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: May 21, 2016
Last updated: Nov. 13, 2018