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General Medicine

Meckel Diverticulum, Pediatric

T. Matthew Shields, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Meckel diverticulum (MD) is the most common congenital abnormality of the gastrointestinal (GI) tract.

  • Derives from remnants of the omphalomesenteric duct

  • The most common clinical pres...

DIAGNOSIS

HISTORY

  • Rectal bleeding

    • In children, the most common presentation is with painless rectal bleeding, which may range from occult blood to frank bright red blood and hemodynamic instability.

    • The ...

TREATMENT

The treatment for MD that are symptomatic and identified is surgical removal. Surgery involves diverticulectomy or partial bowel resection. 

SURGERY/OTHER PROCEDURES

  • Initial management should ...

ADDITIONAL READING

  • McCollough M, Sharieff GQ. Abdominal surgical emergencies in infants and young children. Emerg Med Clin North Am.  2003;21(4):909–935. [View Abstract on OvidInsights]

  • Mendelson ...

CODES

ICD9

751.0 Meckel’s diverticulum 

ICD10

Q43.0 Meckel’s diverticulum (displaced) (hypertrophic) 

SNOMED

37373007 Meckel’s diverticulum (disorder) 

FAQ

  • Q: What is the reason for bleeding due to a MD?

  • A: Bleeding is most commonly due to excessive acid production from ectopic gastric tissue causing mucosal breakdown in intestine downstream from the ...

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Related Images
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Meckel diverticulum. A contrast radiograph of the small intestine shows a barium-filled diverticulum of the ileum (arrow).
Meckel diverticulum. A contrast radiograph of the small intestine shows a barium-filled diverticulum of the ileum (arrow).
Figure 2.43. Terminal ileum, cecum, and appendix. A. The cecum was filled with air until dry, opened, and varnished. Observe the ileocecal valve and ileocecal orifice. The frenulum is a fold, more evident in cadavers, that runs from the ileocecal valve along the wall at the cecocolic junction. B. An ileal diverticulum (Meckel diverticulum) is projecting from the anti-mesenteric side of the intestine (but is shown lying across the mesenteric side in this twisted postion). C. Drawing of the i...
Figure 2.43. Terminal ileum, cecum, and appendix. A. The cecum was filled with air until dry, opened, and varnished. Observe the ileocecal ...
Remnants of the vitelline duct. A. Meckel?s, or ileal, diverticulum combined with fibrous cord (vitelline ligament). B. Vitelline cyst attached to the umbilicus and wall of the ileum by vitelline ligaments. C. Vitelline fistula connecting the lumen of the ileum with the umbilicus.
Remnants of the vitelline duct. A. Meckel?s, or ileal, diverticulum combined with fibrous cord (vitelline ligament). B. Vitelline cyst atta...
FIGURE 118.16. Meckel’s diverticulum. Anterior image at 30 minutes shows an oval focal accumulation of 99mTc-pertechnetate in the right lower quadrant of the abdomen (arrowhead).
FIGURE 118.16. Meckel’s diverticulum. Anterior image at 30 minutes shows an oval focal accumulation of 99mTc-pertechnetate in the right low...
FIG. 8.12. Meckel diverticulum. Anterior image at 30 minutes shows an oval focal accumulation of technetium-99m-pertechnetate in the right lower quadrant of the abdomen (arrowhead).
FIG. 8.12. Meckel diverticulum. Anterior image at 30 minutes shows an oval focal accumulation of technetium-99m-pertechnetate in the right ...
Fig GI 30-5 Meckel's diverticulum (arrow) with a small diverticulum (area of increased density) arising from it.
Fig GI 30-5 Meckel's diverticulum (arrow) with a small diverticulum (area of increased density) arising from it.
Figure 11. 12. CT image of asymptomatic patient with partial anomalous pulmonary venous return. A, Axial image shows vessel draining from right lung into superior vena cava. B, 3D CT Posterior view. 3D image demonstrates no superior right pulmonary vein in the usual location. The anomalous vessel can be seen near the top of the picture. C, 3D CT Anterior view. 3D workstation used to highlight two anomalous right pulmonary veins that were present draining into the superi...
Figure 11. 12. CT image of asymptomatic patient with partial anomalous pulmonary venous return. A, Axial image shows vessel draining from r...
Figure 8.8. Bleeding Meckel diverticulum. Increased isotope concentration in the ileocecal region (arrow) is caused by bleeding. B, bladder.
Figure 8.8. Bleeding Meckel diverticulum. Increased isotope concentration in the ileocecal region (arrow) is caused by bleeding. B, bladder...
FIGURE 110.42 Common variants of yolk stalk malformations. (A,B) Meckel's diverticulum can manifest with inflammation (diverticulitis) or hemorrhage from acid-induced ulceration. (C,D) Meckel's diverticulum in association with abnormal band attached to the abdominal wall predisposing to volvulus and intestinal obstruction. (E) Patent omphalomesenteric duct. (F) Omphalomesenteric sinus and cyst formation.
FIGURE 110.42 Common variants of yolk stalk malformations. (A,B) Meckel's diverticulum can manifest with inflammation (diverticulitis) or h...
Figure 15-16 Meckel diverticulum of the jejunum. Incidental finding at autopsy.
Figure 15-16 Meckel diverticulum of the jejunum. Incidental finding at autopsy.
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