# Meckel's diverticulum - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - 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 date: 2026-08 ## Verified against - No dose - referral pathway, no medicine given in primary care - Meckel Diverticulum - StatPearls - NCBI Bookshelf - disease-level clinical article (meckels-diverticulum-full.txt) ## Treatment metadata - No drug therapy in primary care (Recognition & Referral) ## Complete treatment card ```text MECKEL'S DIVERTICULUM 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) Review status: REVIEWED against 2 sources listed above (2026-08) 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 Source StatPearls "Meckel Diverticulum" - disease-level clinical article Status traced to the source above 1. NO DRUG THERAPY IN PRIMARY CARE (RECOGNITION & REFERRAL)[1st line] Adult 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 Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. 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. Caution 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. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)