Embryogenesis or development of fetus is the most amazing thing that you could ever learn. A perfect embryogenesis results in a healthy newborn. Every organ develops slowly in its own sequence and period of development. During the 4th month of fetal development, your baby’s digestive system and intestine begins developing. During this period your baby starts suckling its thumb and swallows little amount of fluid, just as a part of preparation to survive outside the womb. Normally, the small intestine and the large intestine are smooth tube like structure that is coiled and placed inside the abdomen. The small intestine absorbs the essential nutrients from your food, and the large intestine absorbs water from the undigested food and sends it out as excretion. But in few developing fetus an abnormality in growth occurs between the 5th and 7th week of conception, which results in a condition called as Meckel’s diverticulum.
Understanding Meckel’s diverticulum
Meckel’s diverticulum is a common congenital (from birth) anomaly of the gastrointestinal tract, which is characterized by a small pouch or finger like projection that develops in the lower part of small intestine or near the junction of the small intestine and the large intestine. A Meckel’s diverticulum has normal intestinal layer but it consists of ectopic tissues from stomach and pancreas. This small out pouching has its own blood supply. Meckel’s diverticulum affects about 2% of all infants.
Complications of Meckel’s diverticulum arise the moment it starts producing acid similar to the stomach tissue. As the intestinal tissue is not used to acidic environment, the acid produced results in ulcer formation overtime. This ulceration can irritate the intestine which can rupture, dropping the intestinal content in the abdominal cavity. This may result in a serious infection called as peritonitis. In a few cases, intestinal obstruction may result due to Meckel’s diverticulum where the passage of intestine is blocked, thereby preventing the further passage of the digested food.
Symptoms
Many people with Meckel’s diverticulum show no signs or symptoms. It is estimated that only 1 out of 25 persons will face problems due to Meckel’s diverticulum. The signs vary with age. In children the major problem is bleeding from the rectum and appearance of blood in stool. Adults with Meckel’s diverticulum may suffer from stomach pain, which varies from mild to severe, and vomiting due to intestinal blockage. Few may experience fever, constipation, and swelling of the stomach.
Diagnosis
Meckel’s diverticulum doesn’t need diagnosis and treatment, until it is causes complications. Diagnostic procedure starts with a detailed medical history and physical examination. Later, imaging test will be carried out to detect any abnormality in the intestinal tract. The following procedure may help in diagnosing Meckel’s diverticulum
- Blood test: Intestinal ulcer results in loss of blood and anemia. Therefore a blood test will be done to see if you are anemia or any other infection is present. Stool sample will also be checked for obvious and hidden (occult) blood samples.
- Meckel’s scan: For scanning Meckel’s diverticulum, a radioactive substance called technetium is injected intravenously into your blood stream. This radioactive substance is absorbed by acid secreting stomach tissues, which can be viewed by an X-ray later.
- Rectosigmoidoscopy: Bleeding, blockage and other problems in the rectum and the colon is studied by inserting a small, flexible tube with a camera into the rectum.
- Barium enema and small bowel series: White chalky fluid called barium is given into the rectum as an enema (a quantity of fluid injected into the rectum through the anus). Barium coats the inner wall of large intestine and it shows up in the X-ray. Narrowing of intestine or blockage or any other problem in the large intestine can be detected using this test.
Treatment
Treatment for Meckel’s diverticulum depends on conditions like age, tolerance, severity, your expectation, physician’s opinion, and your opinion. The one recommended treatment for Meckel’s diverticulum is surgical removal of the diverticulum, if bleeding persists. In very rare cases surgical removal of the portion of intestinal segment that contains the diverticulum is recommended, and later the intestine is sewed back. If you are anemic, then iron tablets will be prescribed; if you have lost too much of blood then blood transfusion will be done. Removal of diverticulum can be done either by an open surgery or a laparoscopic surgery.
Outlook
Although Meckel’s diverticulum is a disease with minor complications it is rarely associated with life threatening results. Therefore, it is the duty of parents to check and keep a track of your child’s health. Consult your healthcare provider if your child passes blood or if the stool has blood. Repeated abdominal pain should not be ignored.
