Diverticulitis in children is identified as Meckel’s diverticulitis. It can be described as a small pouch developed along the intestinal wall, near the junction of small and large intestine. The pouch is made from the remnant of tissue from the prenatal development of digestive system. Meckel’s diverticulum generally develops between the 5th and 7th weeks of fetal development. It is not made from the tissue same like the small intestine; instead, the tissue present in diverticula are found in the stomach or pancreas.
Since the condition is present at birth, it comes under congenital health issue. Meckel’s diverticulitis is one of the most common birth defects of digestive system found in about 2% of infants. 1-3% of infants have the symptoms of Meckel’s diverticulum. Children of 2 years of age are most likely to exhibit the symptoms. The symptoms of Meckel’s diverticulitis can be rarely seen in children over age 10. Boys are three times more prone to develop diverticulitis than girls.
Causes and Symptoms of Meckel’s diverticulitis
Meckel’s diverticulitis occurs in fetus during the early stage of pregnancy. The vitelline duct, a connection between the growing fetus and yolk sac, is absorbed into the fetus during the seventh week of pregnancy. Meckel’s diverticulum develops, if the vitelline duct is not completely absorbed. It contains the cells from pancreas and stomach. The cells from the stomach may secret acid, which may cause ulceration and bleeding.
The symptoms are usually seen during the first year of child’s life. However, the symptoms may occur into adulthood too. Some of the common symptoms of diverticulitis in children are abdominal pain and cramping, tenderness near the umbilical region, obstruction of the bowels, which can cause pain, vomiting, bloating, constipation or diarrhea. There may also be gastrointestinal bleeding, which can be seen in the stool. Bleeding is the most common symptom that can be found in children under five. Bleeding is caused by the ulcers, which are developed in the small intestine when stomach acid is secreted by the diverticulum. The most common symptom seen in diverticulitis in children is the passage of a large amount of dark red blood from the rectum, due to which, the stool may appear jelly-like and brick red in color. Passing the stool is generally painless; however, some children may experience abdominal pain. Bowel obstruction is more common in older children and adults. Formation of tumors is the rare symptom of Meckel’s diverticulitis, which may occur in adults.
Diagnosis and Treatment of Meckel’s Diverticulitis
Since many of the diverticulitis symptoms like abdominal pain, tenderness and vomiting can resemble other health conditions, correct diagnosis of Meckel’s diverticulitis is very important. Certain tests like technetium scan, colonoscopy and wireless capsule endoscopy are performed to diagnose Meckel’s diverticulitis. Also, laboratory investigations like blood test to detect infection or anemia as well as stool analysis for the presence of occult blood are carried out.
The treatment for Meckel’s diverticulum is decided depending upon the extent of problem, age, overall health and medical history of the child and child’s tolerance for specific medications, therapies and procedures. If the diverticulum is causing problems like bleeding, then the physician recommends the surgical removal of diverticulum. The surgery involves an incision made in the abdomen and removal of abnormal tissue under general anesthesia. When the operation is complete, the incision is closed with stitches or a special tape called steri-strips. The surgery can be done as open abdominal surgery or laparascopically.