Dawaa Reference

Clinical reference

Meckel's diverticulum

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources4 sources

ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD55.02 - condition scope only, no dose · Meckel Diverticulum - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK499960/ · No dose - referral pathway, no medicine given in primary care · Meckel Diverticulum - StatPearls - NCBI Bookshelf - disease-level clinical article (meckels-diverticulum-full.txt)

Verified against2 documents
  • No dose - referral pathway, no medicine given in primary care
  • Meckel Diverticulum - StatPearls - NCBI Bookshelf - disease-level clinical article (meckels-diverticulum-full.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (7)

  • Most people go through life unaware; the pouch turns up by chance on imaging
  • When it declares itself, usually before age 10 and on average around 2.5 years, with rectal bleeding that does not hurt [rectal bleeding]
  • Blood passed looks like currant jelly or the shade of brick
  • In adults the presentation is melaena instead [melaena]
  • Bleeding normally settles on its own as splanchnic vessels clamp down once volume falls [bleeding]
  • A minority have abdominal pain despite the painless label [abdominal pain]
  • Think of it with repeated or odd intussusception, appendicitis-like illness in someone whose appendix is already out, or an obscure adult gut bleed

Tests (10)

  • Suspect it in any child under two who bleeds painlessly from the back passage
  • It causes roughly half of all lower gut bleeding in under-twos
  • Plain abdominal films help little and barium hardly ever fills the pouch
  • The radionuclide Meckel scan is the most sensitive study; technetium-99m concentrates in the ectopic gastric lining
  • Uptake of the tracer can be boosted with cimetidine, ranitidine or glucagon
  • A labelled red cell scan can also find it while bleeding is ongoing
  • CT of abdomen and pelvis may reveal inflammation or blockage at the pouch
  • Superior mesenteric angiography only helps if blood loss exceeds 0.5 ml/min, and bleeding has often stopped by then
  • Reserve angiography for cases where barium or nuclear studies come back clear
  • Go to laparoscopy or open surgery when tests are equivocal or the patient is haemodynamically unstable

If not this — what else fits (11)

  • Bismuth, iron or spinach discolouring the stool - occult blood is negative
  • Swallowed maternal blood from cracked nipples in infants
  • Milk protein allergy
  • Intussusception
  • Anal fissure
  • Necrotising enterocolitis in neonates and preterm babies
  • Colitis in older children
  • Gastroenteritis
  • HSP or HUS
  • Inflammatory bowel disease
  • Vascular malformation

SourceStatPearls "Meckel Diverticulum" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (RECOGNITION & REFERRAL)

1st line
Adult dose and duration

Congenital remnant of the vitelline duct in the ileum; most are asymptomatic and never diagnosed, but a symptomatic one causes painless lower GI bleeding, obstruction, or diverticulitis mimicking appendicitis in a child. Diagnosis needs imaging (Meckel scan) and surgical referral, not GP drug treatment. - Refer

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Congenital remnant of the vitelline duct in the ileum; most are asymptomatic and never diagnosed, but a symptomatic one causes painless lower GI bleeding, obstruction, or diverticulitis mimicking appendicitis in a child. Diagnosis needs imaging (Meckel scan) and surgical referral, not GP drug treatment.

Cautions
  • Rare in Egyptian primary care.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - Significant blood loss requires urgent volume resuscitation, with possible blood transfusion, as an immediate step alongside surgical referral.
  • RED FLAG - Hemodynamic instability, or inconclusive diagnostic testing, is itself an indication for emergency laparotomy or laparoscopy rather than further work-up.
  • Suspect a Meckel diverticulum in a child with recurrent or atypical intussusception, and in any patient with appendicitis-like symptoms whose appendix has already been removed.
  • Bleeding that stops on its own is not reassurance; it commonly settles because splanchnic vessels constrict as the child becomes hypovolaemic.
  • A normal plain abdominal film does not exclude the diagnosis, and barium studies rarely show the diverticulum.
  • Before treating apparent rectal bleeding, check for ingested bismuth, iron or spinach, which discolour stool and mimic haematochezia.
  • RED FLAG - Significant painless rectal bleeding in a child, signs of bowel obstruction, or peritonitis.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.