

Answer to Medical Mystery Monday #139

So an unexpected event occurred in writing this MMM. The answer I searching for was Meckel’s diverticulum, but many people answered intussusception. In some further research of the symptoms, I discovered that both Meckel’s diverticulum and intussusception have very similar symptoms, so I will grant credit to those who guessed intussusception as well as Meckel’s Diverticulum: pearl, Erin, ColorMaven, ElleKay, Rich S, JP, Ken and Koriger. Great job guys!

Both conditions cause “red jelly” like stools, rectal bleeding, abdominal cramping, and most often occur in males under the age of three.  So how do they differ?

Illustration of what a Meckel's diverticulum looks

Illustration of what a Meckel’s diverticulum looks

Meckel’s diverticulum is a common congenital abnormality, which is present in about 2% of the population. It is a small pouch in the wall of the intestine, and a remnant of embryological tissue from the prenatal development of the digestive system. It is not made of the same type of tissue as the small intestine, but rather, is composed of the same category of tissue found in stomach and pancreas.

Usually, Meckel’s diverticulum is asymptomatic, but if symptoms do occur they usually present before the age of two. The most common symptom is painless rectal bleeding, but more painful symptoms can mimic appendicitis (nausea, vomiting, abdominal pain, lethargy, etc). Diagnosis can be made be opting for a technetium-99m (99mTc) pertechnetate scan (this was the scan used in the previous post), aka a Meckel scan, which detects gastric mucosa. This scan is highly accurate and noninvasive in children. Treatment is not always needed since symptoms usually resolve on by themselves, but if problems persist surgical resection usually cure the problem.

Physical example of a Meckel's diverticulum

Physical example of a Meckel’s diverticulum


In the other corner is intussusception. In this potentially more serious condition, a portion of the intestine folds inward upon itself, creating a ‘collapsible telescope’ style obstruction. Symptoms include the ones demonstrated above, as well as nausea, vomiting, drawing the knees into the abdomen, etc. Unlike Meckel’s diverticulum, intussusception is not a birth defect, and the cause is generally unknown.

While the condition is not always life threatening, it can cause some major problems if not quickly treated. Ultrasound of the abdomen is the first choice in diagnostic imaging, but sometimes a CT scan and/or X-ray of the area is employed as well. A barium and/or air enema can help diagnose as well as treat the problem, but occasionally surgical resection is necessary.

Here is an illustration of an intussusception. See how part of the intestine doubles back to create a ruffle-like effect?



Thanks you all for helping teach me this week! If you have any questions about either of these disorders, feel free to email me at with any questions. I may not know the answer offhand, but I will find an answer for you. And if you have any suggestions for future Medical Mystery Mondays, let me know as well!

Alexandra Taffany