Meckel’s Diverticulum
A leftover pouch on the small bowel that can bleed or obstruct.
What is Meckel’s Diverticulum?
A Meckel’s diverticulum is a small pouch on the wall of the small intestine, left over from a structure that should have disappeared during development. It is the commonest congenital abnormality of the gastro-intestinal tract.
Most people who have one never know. Problems arise when the pouch contains stomach-type lining, which produces acid and ulcerates the adjacent bowel.
That produces the characteristic presentation: sudden, painless passage of dark red blood in the stool in a young child who is otherwise well.
It can also cause obstruction by twisting or acting as the lead point of an intussusception, or become inflamed and mimic appendicitis exactly.
In your language
Meckel’s Diverticulum
A leftover pouch on the small bowel that can bleed or obstruct.
A Meckel’s diverticulum is a small pouch on the wall of the small intestine, left over from a structure that should have disappeared during development. It is the commonest congenital abnormality of the gastro-intestinal tract.
மெக்கல்ஸ் டைவர்டிகுலம்
மெக்கல்ஸ் டைவர்டிகுலம் என்பது சிறுகுடலின் சுவரில் பிறவியிலேயே இருக்கும் ஒரு சிறு பை. பெரும்பாலோருக்கு எந்தப் பிரச்சினையும் ஏற்படாது. ஆனால் சில குழந்தைகளுக்கு அதில் இரைப்பை போன்ற சவ்வு இருப்பதால் புண் ஏற்பட்டு ரத்தப்போக்கு ஏற்படும். வலியில்லாமல் மலத்தில் கருஞ்சிவப்பு ரத்தம் வருவதே முக்கிய அறிகுறி — குழந்தை மற்றபடி நன்றாகவே இருக்கும். அரிதாக குடல் அடைப்பு அல்லது குடல்வால் அழற்சி போன்ற வலியையும் ஏற்படுத்தும். ரத்தப்போக்கு இருந்தால் கண்டிப்பாக பரிசோதிக்க வேண்டும்; சிகிச்சை அறுவை சிகிச்சை மூலம் அந்தப் பையை நீக்குவது.
മെക്കൽസ് ഡൈവർട്ടിക്കുലം
ചെറുകുടലിന്റെ ഭിത്തിയിൽ ജന്മനാ ഉണ്ടാകുന്ന ഒരു ചെറിയ സഞ്ചിയാണ് മെക്കൽസ് ഡൈവർട്ടിക്കുലം. മിക്കവർക്കും ഇത് പ്രശ്നമുണ്ടാക്കില്ല. എന്നാൽ ചില കുട്ടികളിൽ അതിനുള്ളിലെ ആമാശയ സമാന പാളി പുണ്ണുണ്ടാക്കി രക്തസ്രാവത്തിന് കാരണമാകും. വേദനയില്ലാതെ മലത്തിൽ കടും ചുവപ്പ് രക്തം വരുന്നതാണ് പ്രധാന ലക്ഷണം — കുട്ടി മറ്റുവിധത്തിൽ സുഖമായിരിക്കും. അപൂർവമായി കുടൽ തടസ്സമോ അപ്പെൻഡിസൈറ്റിസ് പോലുള്ള വേദനയോ ഉണ്ടാക്കാം. ചികിത്സ ശസ്ത്രക്രിയയിലൂടെ ആ സഞ്ചി നീക്കം ചെയ്യുകയാണ്.
What Parents Notice
Not every child shows every sign. If something on this list matches your child, it is worth an examination rather than a guess.
- Painless passage of dark red or brick-red blood in the stool — the classic presentation, usually under 5 years of age
- Pallor, tiredness or breathlessness from anaemia if bleeding has been repeated
- Tummy pain and vomiting if it is causing obstruction
- Right-sided lower abdominal pain and tenderness indistinguishable from appendicitis when it is inflamed
- A swollen tummy with obstruction
- Occasionally a heavy bleed with collapse, which is an emergency
How It Is Confirmed
- Meckel’s scan (technetium pertechnetate scan) — the specific test, which detects the stomach-type lining within the pouch
- Blood tests including haemoglobin, and cross-matching if bleeding has been significant
- Ultrasound and X-rays, mainly to assess obstruction and to exclude other causes
- Endoscopy and colonoscopy where other sources of bleeding need to be excluded
- Sometimes the diagnosis is made at operation, when a diverticulum is found while looking for a suspected appendicitis
How It Is Treated
- Stabilisation first if the child has bled significantly — fluids, and transfusion where needed.
- The treatment is surgical removal of the diverticulum, usually together with the small segment of adjacent ulcerated bowel.
- This can be done laparoscopically in suitable children, or through a small incision.
- If a Meckel’s diverticulum is found incidentally during another operation, whether to remove it is a judgement made at the time.
- Obstruction and inflammation are treated as surgical emergencies in the same way as any other cause.
Does My Child Need Surgery?
Not every child with Meckel’s Diverticulum needs an operation. These are the situations in which surgery is advised — and the decision is always made after examining your child, never from a description alone.
There has been bleeding attributable to the diverticulum
It has caused obstruction, volvulus or intussusception
It is inflamed or perforated
A symptomatic Meckel’s diverticulum is always removed — the condition does not resolve on its own
What Happens Over Time
Excellent. Once the diverticulum and the ulcerated segment are removed the problem does not return, and there are no long-term restrictions.
This describes what usually happens, not what will happen to your child. The surgeon will give you a specific picture after examining them.
Can It Be Prevented?
It cannot be prevented — it is a remnant left over from development, present from birth.
From First Visit to Going Home
What happens, in order, so that nothing on the day comes as a surprise.
Consultation
Dr. Pratheep Samraj examines your child and goes through the history, earlier reports and any treatment already given.
Investigation
Only the tests that change the decision are asked for — commonly an ultrasound, blood tests, and occasionally an X-ray or a scopy.
Explanation
You are told what the condition is, whether it needs surgery, what happens if you wait, and what the operation involves.
Treatment
If surgery is appropriate it is planned with paediatric anaesthetic cover, with ICU and NICU support available in the hospital.
Follow-up
You go home with written instructions and a review date, and you can reach the hospital by phone or WhatsApp in between.
Hospital stay
Usually 3 to 5 days, longer if the child presented with obstruction or significant bleeding.
Recovery at home
Feeding restarts when bowel function returns, generally within a couple of days. Back to school in 1 to 2 weeks; sport after about a month.
Follow-up
One or two reviews, with a check of haemoglobin if the child was anaemic. No long-term problems are expected after removal.
Please bring with you: all previous scan reports, blood test reports, discharge summaries, records of any earlier operation, current medicines, and your child’s immunisation card. Photographs on your phone of a swelling that comes and goes are genuinely useful.
Please note: this page is general information about Meckel’s Diverticulum, not advice about your child. Timing, suitability for surgery and the expected result differ from child to child and are decided only after clinical evaluation.
Questions Parents Ask
If your question is not here, send it on WhatsApp — you will get an answer from the hospital team.
Dr. Pratheep Samraj
Consultant Paediatric & Neonatal Surgeon · Palliyadi, Kanyakumari
Super-specialist surgical care for newborns, infants and children, with expertise in paediatric urology, congenital anomalies, gastro-intestinal surgery and minimally invasive surgery.
Related Conditions
Painless bleeding from the back passage has a short list of causes.
A Meckel’s scan finds one of the commonest of them, and removing the pouch cures it. Bring the haemoglobin readings over time and any previous endoscopy reports.
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In an emergency — green vomiting in a baby, a groin swelling that will not go back, severe tummy pain, or a newborn not passing urine or meconium — come straight to the hospital or to your nearest emergency department. Do not wait for a reply to a message.