Meckel's diverticulum history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]
Overview
Approximately 98% of people afflicted with Meckel's diverticulum are asymptomatic. If symptoms do occur, they typically appear before the age of two.
The majority of patients with [disease name] are asymptomatic.
OR
The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
History and Symptoms
The most common presenting symptom is painless rectal bleeding, followed by intestinal obstruction, volvulus and intussusception. Occasionally, Meckel's diverticulitis may present with all the features of acute appendicitis. Also, severe pain in the upper abdomen is experienced by the patient along with bloating of the stomach region. At times, the symptoms are so painful such that they may cause sleepless nights with extreme pain in the abdominal area.
- The majority of patients with [disease name] are asymptomatic.
OR
- The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
- Symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
History
Patients with [disease name]] may have a positive history of:
- [History finding 1]
- [History finding 2]
- [History finding 3]
Common Symptoms
- Meckel's diverticulum is usually asymptomatic and is found incidentally on abdominal imaging or surgical exploration performed for a presumptive diagnosis such as acute cholecystitis (exploratory laparotomy, laproscopy).
- The age of presentation for approximately half of all patients is less than 10 years of age.
Common symptoms of Meckel's diverticulum include:
- Lower gastrointestinal bleeding:
- Mechanism: presence of ectopic gastric mucosa leads to acid secretion within the diverticulum and ulceration of the small bowel
- Site: Downstream or adjacent to the diverticulum and not within it
- May be acute or chronic and insidious
- May be a massive bleed
- Usually painless
- More common in children
- In children: presents as maroon or dark red stools
- In adults: presents as melena as transit time through the colon is increased
- Acute abdominal complaints such as pain in the abdomen may be seen in complicated cases, mimicking the presentation of acute appendicitis
Less Common Symptoms
Less common symptoms of Meckel's diverticulum arise in complicated cases:[1][2]
- Symptoms of intussusception, particularly recurrent or atypical intussusception commonly seen in children:
- Pain: crampy abdominal pain with or without rectal bleeding
- Inconsolable crying
- Drawing up of the legs toward the abdomen[3]
- Vomiting usually after the first episode, initially non-bilious but may convert to bilious as obstruction progresses
- Bloody stool or occult blood[4]
- Current jelly stools (mixture of mucus and blood)
- Intermittent pain free intervals in between episodes of pain[1]
- Symptoms of bowel obstruction, more common in adults:
- Colicky abdominal pain (cramping and intermittent) in nature, with spasms lasting a few minutes
- Vomiting
- Nausea
- Constipation
- Symptoms of diverticular inflammation (ie, Meckel's diverticulitis): may present with features similar to acute appendicitis
- Alternating diarrhea and constipation
- Painful abdominal cramps
- Chills or fever
- Symptoms of perforation:[5]
- Severe abdominal pain intensified by movement
- Chills
- Fever
- Nausea
- Vomiting
References
- ↑ 1.0 1.1 West KW, Stephens B, Vane DW, Grosfeld JL (1987). "Intussusception: current management in infants and children". Surgery. 102 (4): 704–10. PMID 3660243.
- ↑ Yamamoto LG, Morita SY, Boychuk RB, Inaba AS, Rosen LM, Yee LL, Young LL (1997). "Stool appearance in intussusception: assessing the value of the term "currant jelly"". Am J Emerg Med. 15 (3): 293–8. PMID 9148991.
- ↑ Mandeville K, Chien M, Willyerd FA, Mandell G, Hostetler MA, Bulloch B (2012). "Intussusception: clinical presentations and imaging characteristics". Pediatr Emerg Care. 28 (9): 842–4. doi:10.1097/PEC.0b013e318267a75e. PMID 22929138.
- ↑ Losek JD, Fiete RL (1991). "Intussusception and the diagnostic value of testing stool for occult blood". Am J Emerg Med. 9 (1): 1–3. PMID 1985640.
- ↑ "Intestinal Perforation Clinical Presentation: History, Physical Examination".