Summary
Definition
History and exam
Key diagnostic factors
- age <2 years
- passage of bright red blood per rectum (hematochezia)
- intractable constipation (obstipation)
Other diagnostic factors
- male sex
- nausea and vomiting
- abdominal cramps
- lower abdominal pain
- diffuse abdominal tenderness
- palpable abdominal mass
- hypotension/tachycardia
Diagnostic investigations
1st investigations to order
- CBC
- technetium-99m pertechnetate scan ("Meckel scan")
- plain abdominal radiography
- CT scan of the abdomen and pelvis
- ultrasound of the abdomen
Investigations to consider
- contrast enema
- small bowel enteroclysis
- mesenteric angiography
- surgical exploration of the abdomen
Treatment algorithm
Contributors
Authors

Associate Professor of Surgery
Harvard Medical School
Brigham and Women's Hospital
Boston
MA
Disclosures
AT consults for Medtronic, sees patients on behalf of Partners Healthcare and is the recipient of grants from NIH, Siemens and Sanofi, none of which conflicts with this topic.
Dr Ali Tavakkoli would like to gratefully acknowledge Dr Gordon G. Wisbach, a previous contributor to this topic. GGW declares that he has no competing interests.
Peer reviewers
Professor of Surgical Oncology
Consultant Colorectal Surgeon
The Royal London Hospital
London
UK
Disclosures
SD declares that he has no competing interests.
Assistant Professor of Pediatrics
University of Alberta
Edmonton
Alberta
Canada
Disclosures
WEM declares that he has no competing interests.
Associate Professor of Surgery
University of Maryland
Baltimore
MD
Disclosures
SK declares that he has no competing interests.
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