Paediatrics: Meckel’s diverticulum

Meckel’s diverticulum

Meckel’s diverticulm (MD) is:

• A persistence of the embryonic vitelline duct that normally involutes during late foetal development.

• Present in 2% of the population and the majority are asymptomatic.

• A cause of GI bleeding, obstruction, inflammation, and umbilical discharge.

Management

• Rectal bleeding from a MD is painless, fresh, and sufficient to cause a drop in haemoglobin. Sometimes a ^99mTc-pertechnetate isotope scan will identify a MD.

·Laparotomy: persistent or recurrent bleeding requires a laparotomy even if the scan is –ve. Diverticulitis or perforation of a MD is clinically indistinguishable from appendicitis.

Symptomatic MD should be resected.