The small intestine has an anomaly called Meckel diverticulum that causes it to protrude outward and is congenital (existing from birth). At 2% to 4% of the population, it is the most prevalent birth abnormality in the digestive system. Meckel diverticulum, however, usually has no symptoms, and most persons with it may never be aware that they have it. Meckel diverticulum can occasionally result in problems including bleeding, blockage, infection, or malignancies.
Meckel diverticulum develops in the early stages of pregnancy when a portion of the vitelline duct, which connects the growing baby to the yolk sac, fails to shut entirely. By the seventh week of pregnancy, the vitelline duct usually closes, but occasionally a little section of it persists and forms a sac or pouch on the small intestine's bottom wall. Tissue from the pancreas, stomach, or other organs may be present in the pouch; this tissue can exude acids or other substances that irritate the intestines or lead to ulcers.
Most people with Meckel diverticulum do not have any symptoms and are unaware of their condition. However, some people may experience one or more of the following symptoms, especially during childhood or early adulthood:
Painless rectal bleeding, which may be bright red or dark and tarry
Abdominal pain, cramping, or tenderness, especially near the navel
Nausea, vomiting, or loss of appetite
Bloating, constipation, or diarrhea
Fever, chills, or signs of infection
Anemia, due to chronic blood loss
The kind and degree of the consequence might affect the Meckel diverticulum symptoms. The most frequent side effect is gastrointestinal bleeding, which is typically brought on by intestine ulcers that develop as a result of the pouch's acid production. Bleeding may vary in intensity from moderate to severe and can occur intermittently or continuously. Intestinal obstruction, which happens when the pouch twists, becomes inflamed, or obstructs the passage of food or feces, is the second most frequent consequence. Severe discomfort, nausea, and distension in the abdomen can all be symptoms of obstruction. Diverticulitis (pouch inflammation or infection), perforation (pouch rupture), and tumors (benign or malignant growths in the pouch) are other less frequent problems.
Meckel diverticulum can be challenging to identify as its signs and symptoms might be mistaken for appendicitis, peptic ulcer disease, or inflammatory bowel disease. A patient's medical history, physical examination, and imaging tests are often used to make the diagnosis. The following are a few tests that might be performed to identify Meckel diverticulum:
Blood tests, to check for anemia, infection, or inflammation
Meckel scan, a nuclear medicine test that uses a radioactive tracer to detect the presence of stomach tissue in the pouch
X-rays, ultrasound, or CT scan, to visualize the pouch and its location, size, and shape
Endoscopy or colonoscopy, to examine the inside of the intestine and look for ulcers, bleeding, or tumors
Biopsy, to take a sample of tissue from the pouch and analyze it under a microscope
The treatment of Meckel diverticulum depends on the symptoms and complications of the condition. Some people with Meckel diverticulum may not require any treatment, while others may need medication, surgery, or both. Some of the treatment options include:
Medication, to reduce the acid production in the pouch and heal the ulcers, or to treat the infection or inflammation in the pouch
Surgery is required to cut the pouch and the intestine's damaged portion and rejoin the ends. Patients with bleeding, blockage, perforation, tumors, or severe or persistent symptoms are typically advised to have surgery. Open or laparoscopic (minimally invasive) surgery can be performed, based on the circumstances and the surgeon's desire.
Blood transfusion, to replace the blood loss due to bleeding
Fluid and electrolyte replacement, to correct the dehydration or imbalance caused by vomiting or diarrhea
There is no known way to prevent Meckel diverticulum, as it is a congenital defect that occurs before birth. However, some measures can be taken to prevent or reduce the risk of complications, such as:
Eating a balanced and healthy diet, and avoiding foods that may irritate the stomach or intestine, such as spicy, acidic, or fatty foods
Drinking plenty of fluids, and staying hydrated
Taking medications as prescribed by the doctor, and following the instructions carefully
Seeking medical attention promptly if any symptoms or signs of complications occur, such as bleeding, pain, fever, or vomiting
Having regular check-ups and screenings, especially for people who have a family history of Meckel diverticulum or other gastrointestinal disorders
