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Meckel's diverticulum
From WikEM
(Redirected from Meckel diverticulum)
Contents
Background
- Most common cause of significant lower gastrointestinal bleeding in children
- Due to vitelline duct not disappearing by 7 wks
Rule of 2's
- 2% of population
- 2 ft from ileocecal valve
- 2% become symptomatic
- 2 years of age (45%)
- 2 x more common in boys
Evaluation
- Rectal bleeding (+/- pain)
- Most common presentation in <5yrs
- May be intermittent or massive
- Obstruction (can cause intussusception)
- Diverticulitis
- Umbilical fistula
- 1/3 will perforate
Workup
- Meckel's scan (test of choice), also known as technetium-99m pertechnetate scan
Differential Diagnosis
Lower gastrointestinal bleeding
- Upper GI Bleeding
- Diverticular disease
- Vascular ectasia
- Inflammatory bowel disease
- Infectious colitis
- Mesenteric Ischemia
- Meckel's diverticulum
- Malignancy / polyps
- Hemorrhoids
- Aortoenteric fisulta
- Rectal foreign body
- Rectal ulcer (HIV, Syphilis, STI)
- Anal fissure
Management
- NGT
- IVF
- pRBCs prn
- Surgery consult
