What is Meckel's Diverticulum?
Meckel's diverticulum is a congenital anomaly of the gastrointestinal tract resulting from the incomplete obliteration of the vitelline duct. It presents as a true diverticulum, containing all layers of the intestinal wall. This condition is the most common congenital malformation of the small intestine, affecting approximately 2% of the population.
What Causes Meckel's Diverticulum?
The condition arises during fetal development when the vitelline duct, which connects the developing gut to the yolk sac, fails to completely regress. The remaining segment forms a diverticulum, typically located on the anti-mesenteric border of the ileum, around 2 feet from the ileocecal valve.
What are the Symptoms?
Many children with Meckel's diverticulum remain asymptomatic. However, symptoms can manifest and may include:
Painless rectal bleeding: Often the most common presentation in children.
Abdominal pain: Mimicking appendicitis, especially if there is inflammation.
Intestinal obstruction: Due to volvulus around a fibrous band or intussusception.
Diverticulitis: Inflammation akin to appendicitis but localized to the diverticulum.
Surgical resection: Indicated for symptomatic cases, involving removal of the diverticulum and, if necessary, the surrounding ileal segment.
Observation: For asymptomatic patients, especially if incidentally found, as prophylactic removal remains controversial.
What is the Prognosis?
The prognosis for children diagnosed with Meckel's diverticulum is generally excellent if appropriately managed. Surgical resection in symptomatic cases often leads to full recovery with minimal risk of recurrence or long-term complications. However, untreated complications can lead to more severe outcomes.
Unexplained gastrointestinal bleeding
Recurrent abdominal pain
Signs of intestinal obstruction, such as vomiting, abdominal distension, or severe constipation
Signs of infection like fever, severe pain, or noticeable changes in behavior or activity levels
