Meckel’s Diverticulum

Meckel’s diverticulum is a small appendix of the small intestine that some people have and that can cause problems in childhood such as abdominal pain, bleeding, and intestinal obstruction.

It is the most common congenital anomaly of the gastrointestinal tract . Meckel’s diverticulum is commonly referred to with the rule of 2 :

  • It occurs in 2% of the population (more accurately, between 1% and 4%).
  • It is more common in boys than girls, with a 2: 1 ratio.
  • It is most often located 2 feet (60 cm) from the ileocecal valve.
  • It is generally about 2 cm in diameter.
  • It can contain 2 different types of tissues: gastric and pancreatic.
  • It is more common before 2 years.

What is Meckel’s diverticulum?

Meckel’s diverticulum is a remnant of the omphalomesenteric duct . During a phase of intrauterine development, the primitive intestine communicates with the yolk sac that is located outside the embryo. This conduit that communicates them is called the omphalomesenteric conduit. As the embryo develops, both the yolk sac and the omphalomesenteric duct progressively disappear, but some remnant of this duct may remain in a small percentage of the population and this is what we call Meckel’s diverticulum.

What problems can it give?

Many people with this diverticulum are asymptomatic, that is, it does not give them problems. In the case of showing one’s face, it is usually done in early childhood , especially in the first two years of life.
Meckel’s diverticulum can contain stomach mucosa that is capable of secreting hydrochloric acid, which can cause ulceration, bleeding and possible intestinal perforation.
Around 33% of the patients present symptoms, while 16% of the patients remain asymptomatic, with Meckel’s diverticulum being an accidental finding during a surgical intervention indicated by a different pathology.
When Meckel’s diverticulum presentsclinical manifestations , these are usually nonspecific and therefore the diagnosis is difficult and the diagnosis is suspected when complications develop, in 4-5% of cases. The incidence of complications decreases as age increases. The most common complication in children is hemorrhage .
In adults the most common complication is obstruction, followed by diverticulitis.
In the medical literature, the development of malignant neoplasms in patients with Meckel’s diverticulum has been described between 0.5% and 4.9% of patients.

What are the symptoms?

  • Acute abdominal pain located in the central or right part of the abdomen, and clinically confused with acute appendicitis. It can be accompanied by bleeding in the stool, but not always.
  • Presence of blood in the stool without abdominal pain that can even cause major bleeding problems and shock.
  • It can be the cause of intussusception , which causes abdominal pain, vomiting, irritability, and a palpable mass on the right side of the abdomen. This clinic occurs more frequently in children under six years of age.
  • Intestinal obstruction . It is a very serious condition where the bowel loops wrap around the omphalomesenteric ligament. The child has significant discomfort, vomiting, pain, bloating, and severe constipation.

How is it diagnosed?

  • The diagnosis is made differently depending on whether the clinical picture is acute or subacute.
  • When the child’s symptoms are so severe that it is necessary to go to the operating room , it is at the time of the intervention that the anatomical structure is observed and the cause of massive bleeding, acute abdominal pain or intestinal obstruction with the Meckel’s diverticulum.
  • In cases where chronic bleeding in the stool is suspected without pain or vital urgency, the diagnosis is made by scintigraphy with an isotope that is captured by the gastric mucosa that the Meckel’s diverticulum has inside, showing its existence and location. Once diagnosed, surgery is scheduled to remove it and prevent future problems.

What you should know…

  • In the case of showing one’s face, it is usually done in early childhood, especially in the first two years of life. The most common complication in children is hemorrhage.
  • It can manifest with acute abdominal pain and blood in the stool.
  • Once diagnosed, surgery is scheduled to remove it and prevent future problems.

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