What Is Meckel's Diverticulum?

In This Article
Table of Contents

Meckel's diverticulum is a bulge or outpouching in the last part of the small intestine, which is called the ileum. It is a condition that is present at birth (also called a congenital condition) and is the result of an incomplete process in the development of the fetus. Most people who are born with a Meckel’s diverticulum don’t have any symptoms and may not know that they have one. It’s estimated that between 2% and 4% of people are born with a Meckel's diverticulum, making it the most common congenital condition affecting the digestive system. If necessary, this condition may be treated with surgery.

Meckel's Diverticulum Symptoms

In most cases, Meckel’s diverticulum does not cause any symptoms. In others, symptoms may be intermittent. That is to say, there could be bloody stools, pain, or other symptoms that come and go.

The signs and symptoms of Meckel’s diverticulum can include:

The symptoms of Meckel’s diverticulum are nonspecific, which can make the condition challenging to diagnose. Any of the above signs or symptoms in a child is a reason to seek medical treatment from the pediatrician, or, if the symptoms are severe, the emergency department.

Blood in the stool is never normal, at any age, and should be discussed with a physician. Bleeding in the digestive tract that is excessive is an emergency and may need surgery.

Risk factors for having symptoms in adults include being male, younger than the age of 50, a diverticulum that is larger (bigger than 2 centimeters), the presence of ectopic tissue (tissue that is from outside the small intestine), a longer diverticulum (broad-based), and an attached fibrous band.

The diverticulum may be made of different types of cells, depending on the type that formed. If it formed from intestinal cells, which is true for the majority of cases, there might not be any symptoms or any symptoms that become bothersome enough to seek treatment. 

A Meckel’s diverticulum may also form from stomach cells or pancreatic cells. In this case, there could be symptoms because these cells aren’t part of a normal small intestine. However, when symptoms do occur, they may start in infancy. For children under the age of 5 years, bleeding in the digestive tract is the most common symptom. This is due to the stomach acid that is released by the diverticulum and causes ulcers in the small intestine.

Older children may experience a bowel obstruction, where stool is unable to pass through the intestines. Adults may also experience symptoms if they have not had surgery to repair the diverticulum. 

Causes

Meckel's diverticulum is formed during gestation. A structure called the omphalomesenteric duct or the vitelline duct connects the yolk sac of the embryo to the beginnings of the digestive tract. Normally, this duct is replaced by the placenta between the fifth and seventh week of gestation. If the duct is not completely gone and fully replaced during that time it can result in a Meckel's diverticulum.

There are other conditions that can occur from a persistent vitelline duct, including a vitelline fistula. The Meckel’s diverticulum extends through all of the layers of the wall of the small intestine.

Diverticulum is another word for a sac or a pouch.

Diagnosis

If Meckel’s diverticulum is diagnosed, it usually happens in early childhood. Many cases are diagnosed before a child turns 10 years old but some are not found until the teenage years. Meckel’s diverticulum can be a challenge to diagnose. This is because many of the symptoms are nonspecific and could be caused by a number of different conditions. Signs and symptoms might also be troublesome for a time and then stop again.

In some cases, a Meckel’s diverticulum may be diagnosed in an adult as an incidental finding. That is, it is found during an examination or treatment for another disease or condition. Diagnosis is difficult without surgery. Most often, surgery is done laparoscopically in order to diagnose a Meckel’s diverticulum.

A test called technetium-99m pertechnetate scintigraphy is the one that’s most often done to diagnose a Meckel’s diverticulum. It’s also called a Meckel scan. In this test, a substance called technetium-99m, which has a small amount of radiation in it, is injected into a vein. A gamma camera, which can detect radiation, is used to take a series of images of the abdomen. If the technetium-99m is inside the Meckel’s diverticulum, it will be seen on the images. This test is more helpful in diagnosing a Meckel’s diverticulum in children than it is in adults.

Other tests that may be used either to try and make a diagnosis or to look for complications include plain radiography, barium studies, angiography, computerized tomography (CT), and ultrasonography.

Treatment

If there are no symptoms, a Meckel’s diverticulum might not need any treatment. This might be true if the diverticulum is found incidentally, such as during surgery or the diagnostic process for another disease or condition.

If surgery is recommended, the diverticulum and a portion of the small intestine would be removed. Laparoscopic surgery will be preferred and used if that is a possibility. In this surgery, several small incisions are made and the surgery is done through the use of a tube that has a camera on the end. Open surgery, which is done through the use of a larger incision, might also be done in certain cases.

Prognosis

Once the Meckel’s diverticulum is removed, it can no longer cause symptoms. Complications may occur in a small number of cases where there is ectopic tissue or there is fibrous tissue. If any of this tissue is left behind after removing the diverticulum they may cause additional symptoms. However, in most cases, there are no further complications.

A Word From Verywell

A saying often attributed to Charles W. Mayo is that "Meckel's diverticulum is frequently suspected, often looked for, and seldom found.” While it’s true that Meckel's diverticulum is considered a common disorder, it often does not cause symptoms and most of the time won’t require treatment. Diagnosis can be a challenge, but when a diverticulum is diagnosed, surgery can be done to remove it. Children and adults who have surgery to remove and repair a Meckel's diverticulum usually make a full recovery. The diverticulum won’t return because it is a congenital defect that one is born with and not something that develops over time. 

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. McGrath AK, Suliman F, Thin N, Rohatgi A. Adult intussusception associated with mesenteric Meckel's diverticulum and antimesenteric ileal polyp. BMJ Case Rep. 2019;12:e230612. doi:10.1136/bcr-2019-230612

  2. Hansen CC, Søreide K. Systematic review of epidemiology, presentation, and management of Meckel's diverticulum in the 21st centuryMedicine (Baltimore). 2018;97(35):e12154. doi:10.1097/MD.0000000000012154

  3. Lequet J, Menahem B, Alves A, Fohlen A, Mulliri A. Meckel's diverticulum in the adultJ Visc Surg. 2017;154(4):253‐259. doi:10.1016/j.jviscsurg.2017.06.006

  4. Campbell BT. Meckel’s diverticulum and other omphalomesenteric duct remnants. In: Pediatric Gastrointestinal and Liver Disease (Fourth Edition). W.B. Saunders; 2011. 

Additional Reading