Meckel’s Diverticulum
Gastrointestinal
Context
- Diverticulum of the small intestine.
- The most common congenital abnormality of the GI tract.
- May contain ectopic tissue: gastric, pancreatic.
- Classically occurs in 2% of the population, is 2 inches long and 2 feet from ileocecal junction (Rule of Twos).
- Important mimicker of another disorder (e.g. Crohn’s disease, appendicitis, PUD).
Diagnostic Process
- Consider with unexplained abdominal pain, nausea/vomiting, or painless rectal bleeding.
- Complications include bleeding, obstruction, intussusception, diverticulitis, perforation, and tumors.
- Ultrasonography or CT first line to rule in/out other pathologies.
- Most specific test is technetium-99m pertechnetate scan (Meckel’s scan) especially if bleeding.
Recommended Treatment
- Surgical excision.
- Complications are similar to those of any small bowel surgery.
Criteria For Hospital Admission
- As per general surgeon.
Quality Of Evidence?
High
We are highly confident that the true effect lies close to that of the estimate of the effect. There is a wide range of studies included in the analyses with no major limitations, there is little variation between studies, and the summary estimate has a narrow confidence interval.
Moderate
We consider that the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. There are only a few studies and some have limitations but not major flaws, there are some variations between studies, or the confidence interval of the summary estimate is wide.
Low
When the true effect may be substantially different from the estimate of the effect. The studies have major flaws, there is important variations between studies, of the confidence interval of the summary estimate is very wide.
Justification
Related Information
Reference List
Martin J. P., Connor P. D., Charles K. Meckel’s diverticulum. Am Fam Physician. 2000 Feb 15;61(4):1037-42, 1044.
Cochran W. J. Meckel diverticulum [Internet]. Rahway (US): Merck Manuals Consumer Version; 2021 Aug [updated 2022 Sep; cited 2023 Jan 8]. Available from: https://www.merckmanuals.com/en-ca/home/children-s-health-issues/digestive-disorders-in-children/meckel-diverticulum
Tavakkoli A. Meckel’s diverticulum [Internet]. [place unknown]: BMJ Publishing Group; 2022 Apr 8 [updated 2022 Dec 9; cited 2023 Jan 8]. Available from: https://bestpractice.bmj.com/topics/en-gb/804
Javid P. J., Pauli E. M. Meckel’s diverticulum [Internet]. [place unknown]: Wolters Kluwer; 2022 Feb 1 [updated 2022 Dec; cited 2023 Jan 8]. Available from: https://www.uptodate.com/contents/meckels-diverticulum#H1124079404
Raftery A. T., Delbridge M. S., Wagstaff M. J. D., Bridge K. Churchill’s pocketbook of surgery. 5th ed. [place unknown]: Elsevier Canada; 2021.
RESOURCE AUTHOR(S)
DISCLAIMER
The purpose of this document is to provide health care professionals with key facts and recommendations for the diagnosis and treatment of patients in the emergency department. This summary was produced by Emergency Care BC (formerly the BC Emergency Medicine Network) and uses the best available knowledge at the time of publication. However, healthcare professionals should continue to use their own judgment and take into consideration context, resources and other relevant factors. Emergency Care BC is not liable for any damages, claims, liabilities, costs or obligations arising from the use of this document including loss or damages arising from any claims made by a third party. Emergency Care BC also assumes no responsibility or liability for changes made to this document without its consent.
Last Updated Oct 10, 2023
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