Introduction:
Meckel diverticulum is a congenital pouch that is present from the time of birth. It is an outpouching or bulge in the lower part of the small intestine. Outpouching is the leftover part of the umbilical cord and is considered one of the most common congenital defects of the digestive system. Although the diverticulum stays in the intestine without any symptoms, if it causes symptoms, it should be treated surgically. Meckel diverticulum can affect approximately two to three percent of the population, but the onset of symptoms is very rare. The condition is considered equally common in males and females, but males have three times more prevalence than females.
Where Is Meckel Diverticulum Located?
The position and length of the diverticulum follow the "rule of 2s". According to the rule, the condition is found in around 2 percent of adults and measures 2 inches in length. The location of Meckel diverticulum is 2 feet from the ileocecal valve. It also contains two types of tissues, namely gastric and pancreatic.
What Are the Causes of Meckel Diverticulum?
As stated, Meckel cartilage is a congenital disorder formed in the fetal stage of the child inside the womb. The vitelline duct, which connects the fetus with the yolk sac, is generally absorbed in the seventh week of the intrauterine life. If this vitelline is not completely absorbed, it forms Meckel diverticulum. Meckel diverticulum contains cells from both the stomach and the pancreas. The cells originating from the stomach cause acid secretion, leading to bleeding and ulcers.
What Are the Symptoms Caused by Meckel Diverticulum?
The symptoms of Meckel diverticulum may be visible in children and adults. The most common symptom in children under five years of age is bleeding, generally caused by ulcers formed in the small intestine. These ulcers are formed due to acid secreted by stomach cells.
The symptoms seen in Meckel diverticulum are:
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Abdominal pain and cramping.
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Tenderness was observed near the belly button (navel).
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Blockage of the bowels leads to obstruction of the contents of the intestines from passing forward. This obstruction can lead to diarrhea, constipation, bloating, and vomiting.
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Bleeding in the gastrointestinal tract is seen on the stools.
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Inflammation of the diverticulum leads to swelling of the intestinal walls.
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Loss of red blood cells or decreased hemoglobin in the body (anemia).
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These are one of the rare symptoms of the diverticulum which are seen in adults (tumors).
How to Diagnose Meckel Diverticulum?
Meckel diverticulum is difficult to diagnose depending on the symptoms, such as vomiting, nausea, tenderness, and abdominal pain, as these symptoms are observed in many gastrointestinal conditions.
Certain tests help to diagnose and evaluate Meckel diverticulitis; these are:
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Radiographic Scan: The radioactive material is injected into the body, which is easily absorbed by the stomach cells of the diverticulum. This is then observed with the help of a camera.
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Colonoscopy: A small flexible tube with a camera is inserted through the rectum into the colon and the small intestine to look for blockage and bleeding.
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Wireless Capsule Endoscopy: This technique is used without a thin tube. A small camera is inserted inside the body by swallowing it. If the scan has to be performed on a young child who cannot swallow the pill, they can be given this when they are sleeping.
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Meckel Scan: It is a nuclear study done by injecting technetium-99m which is consumed in by the ectopic gastric mucosa and helps to get a visual of Meckel diverticulum. The uptake of the dye can be enhanced by adding cimetidine or glucagon. In cases of active bleeding, there is evident contrast extravasation on the angiogram.
What Is the Treatment for Meckel Diverticulum?
Generally, the symptoms are not shown by Meckel diverticulum, so they are left untreated for a lifetime in the intestines. In cases of symptoms such as bleeding, ulcers, or blockage in the intestine, surgical removal of Meckel diverticulum is advised. In this technique, the Meckel diverticulum, along with surrounding intestines, are cut and removed, and the ends of the remaining intestines are attached.
The procedure of laparoscopy performs this surgery. Laparoscopy is a minimally invasive surgery in which a small incision is made and a camera inserted, which helps to locate the diverticulum. Once the Meckel diverticulum is detected, another incision is made to access the instruments at the site of the condition. The Meckel diverticulum is cut and removed along with the intestine. This procedure is preferred over the traditional method of long incisions.
What Are the Precautions Taken After Meckel Diverticulum Removal?
The outgrowth of Meckel diverticulum had no function in the body, but the intestinal portion cut along with it was functional.
Thus, few precautions should be taken after the surgery, such as:
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Intake a diet without very complex nutrients takes a lot of effort in digestion and absorption, as the intestine is coping after the surgery.
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Intake of lots of water and fluids to avoid strain on intestines.
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Proper follow-up with the doctors and following all the precautions and instructions provided by the healthcare professionals.
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Intake of medications for healing of the tissues.
Conclusion:
Meckel diverticulum is a congenital outgrowth formed around the seventh week of pregnancy due to incomplete absorption of the vitelline duct. The pouch contains both stomach and intestine cells and secretes stomach acids. The stomach acids may lead to ulcers and bleeding in the intestine. Usually, Meckel diverticulum is asymptomatic and does not bother throughout life. However, in some cases, it may cause ulcers and bleeding and thus need to be removed. The technique of laparoscopy can carry out the surgical removal of Meckel diverticulum.
