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
Risk factors
- there are no known risk factors
Diagnostic tests
1st tests to order
- CBC
- technetium-99m pertechnetate scan ("Meckel scan")
- CT scan of the abdomen and pelvis
- ultrasound of the abdomen
Tests to consider
- contrast enema
- mesenteric angiography
- endoscopic exploration of the small intestine
- surgical exploration of the abdomen
Treatment algorithm
asymptomatic
symptomatic
Contributors
Authors
Ali Tavakkoli, MBBS, FRCS, FACS
Chief
Division of General and GI Surgery
Brigham and Women's Hospital
Associate Professor of Surgery
Harvard Medical School
Boston
MA
Disclosures
AT declares that he has no relevant financial conflicts related to this topic.
Acknowledgements
Dr Ali Tavakkoli would like to gratefully acknowledge Dr Gordon G. Wisbach, a previous contributor to this topic.
Disclosures
GGW declares that he has no competing interests.
Peer reviewers
Sina Dorudi, PhD, FRCS, FRCS (Gen)
Professor of Surgical Oncology
Consultant Colorectal Surgeon
The Royal London Hospital
London
UK
Disclosures
SD declares that he has no competing interests.
Wael El-Matary, MBBCh, MD, MRCP
Assistant Professor of Pediatrics
University of Alberta
Edmonton
Alberta
Canada
Disclosures
WEM declares that he has no competing interests.
Stephen Kavic, MD
Associate Professor of Surgery
University of Maryland
Baltimore
MD
Disclosures
SK declares that he has no competing interests.
Differentials
- Appendicitis
- Non-Meckel diverticulum-related intussusception
- Biliary colic
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