Snapshot A 12-month-old child has iron-deficiency anemia refractory to iron therapy. His stool is repeatedly positive for occult blood. The parents bring the child to the ER because they notice some blood in his stool. To solidify the lesson, students are shown a gross pathology specimen. Introduction Congenital outpouching of the small intestine Caused by persistance of vitelline duct Found 2 feet from ileocecal valve in most cases Epithelium may be acid-secreting or pancreatic Presents in the first two years of life Epidemiology occurs in 2% of the population most common congenital anomaly of the GI tract most frequently occurs in children < 2 years old Presentation Symptoms rectal bleeding abdominal distention Physical exam painless rectal bleeding can present with signs of obstruction Evaluation Meckel scintigraphy diagnostic golden standard rarely seen on barium study ABX sometimes can be observed with plain films Differential Bowel obstruction, Hirschsprung's disease Treatment Surgical intervention surgical excision of diverticulum indicated when there is active bleeding resection along with adjacent intestinal segment Prognosis, Prevention, and Complications Prognosis very good to excellent some cases are asymptomatic and discovered incidentally Prevention none Complications may be complicated by diverticulitis, volvulus, and intussusception