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Meckel’s Diverticulum
Dr. Sulaiman Bin Yusof
MbChB (Sheffield)
M.Med (Surg)
FRCSEd (Gen Surg)
蘇萊曼·尤索夫博士
Meckel’s diverticulum is a small pouch that forms in the lower part of the small intestine from birth. It occurs when a structure from foetal development, known as the vitelline duct, does not close fully, leaving a pocket in the intestine.
Most people with Meckel’s diverticulum have no symptoms, and it is often discovered accidentally during tests or procedures for other health concerns. However, in some cases, it can cause digestive problems that require medical attention.
Symptoms of Meckel’s Diverticulum
While many people with Meckel’s diverticulum have no symptoms, complications may lead to noticeable digestive issues. Symptoms can include:
Abdominal Pain: Discomfort typically occurs near the belly button or lower abdomen. Pain may range from mild to severe, especially if the diverticulum contains acid-secreting tissue leading to ulceration.
Blood in Stool: Ulcers within the diverticulum can cause bleeding, resulting in bright red or dark blood in the stool. This bleeding is often painless and more noticeable in children.
Vomiting and Abdominal Bloating: In some cases, Meckel’s diverticulum can cause a blockage in the intestine, particularly in younger children. This can lead to symptoms such as vomiting, abdominal bloating, and constipation as food and waste struggle to pass through the digestive tract.
Fatigue from Anemia: Chronic bleeding from the diverticulum may result in anaemia, characterised by fatigue, pale skin, and shortness of breath due to reduced oxygen levels in the blood.
Causes and Risk Factors
Foetal Development
Meckel’s diverticulum forms when the vitelline duct, which connects the developing intestines to the yolk sac in the fetus, fails to close completely, leaving a small pouch in the small intestine.
Ectopic Tissue
The diverticulum may contain stomach or pancreatic tissue, which can produce acid and increase the risk of ulcer formation and bleeding.
Higher Risk in Males
Symptoms and complications from Meckel’s diverticulum are more common in males than females, with symptomatic cases appearing more often in children under 10.
Link to Other Birth Conditions
Individuals who are born with certain conditions, such as oesophagal or rectum issues, may be more likely to develop Meckel’s diverticulum.
Diagnosing Meckel’s Diverticulum
Meckel’s diverticulum can be difficult to diagnose because its symptoms are often similar to those of other digestive disorders. The following methods may be used:
Meckel’s Scan
This imaging test involves injecting a small amount of radioactive substance into the bloodstream. The substance travels to areas with stomach-like tissue, which can be detected by a scanner. This scan is most effective in younger patients, where it can help locate the diverticulum.
Endoscopy and Colonoscopy
In an endoscopy, a camera is inserted through the mouth to view the upper digestive tract, while in a colonoscopy, it is inserted through the rectum to view the large intestine. Although these tests may not always detect Meckel’s diverticulum, they are helpful in identifying or ruling out other conditions that may cause similar symptoms.
Imaging Studies
CT and MRI scans create detailed images of the internal organs. They can sometimes reveal abnormalities in the small intestine, such as a diverticulum, aiding in diagnosis.
Blood Tests
Blood tests can check for anaemia (low red blood cells), which may occur if there is ongoing blood loss due to Meckel’s diverticulum. Detecting anaemia can help doctors determine if bleeding is part of the problem.
Treatment Options for Meckel’s Diverticulum
Non-Surgical Treatment
Observation
In cases without symptoms, close monitoring is often recommended instead of immediate intervention. Patients should be vigilant for any new symptoms, like abdominal pain or rectal bleeding, and promptly report these to their colorectal specialist to reassess the need for treatment.
Medication
For mild symptoms, medications may help manage discomfort and prevent complications. Proton pump inhibitors (PPIs) can be prescribed to reduce stomach acid, which helps prevent ulcer formation in cases where the diverticulum contains acid-producing tissue. However, medication alone may not resolve all potential issues and is generally considered a temporary measure.
Surgical Treatment
Diverticulectomy
This surgical procedure removes the diverticulum from the wall of the small intestine. It is typically recommended if symptoms such as bleeding, pain, or infection are present. During surgery, the surgeon removes the pouch and then stitches the intestine closed. This procedure effectively prevents further complications such as recurrent bleeding or intestinal blockages.
Bowel Resection
If the diverticulum has caused significant damage to the surrounding intestine, a portion of the affected intestine may need to be removed along with the diverticulum. This procedure removes the damaged section, and the surgeon reconnects the healthy ends of the intestine to restore normal bowel function. It is generally considered for complex cases where diverticulectomy alone may not be sufficient.
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Dr. Sulaiman Bin Yusof
MbChB (Sheffield)
M.Med (Surgery)
FRCSEd (General Surgery)
蘇萊曼·尤索夫博士
Dr. Sulaiman Bin Yusof is a Senior Consultant colorectal and general surgeon in Singapore with over 15 years of specialist experience across public and private practice. Trained in the United Kingdom and awarded a Ministry of Health Fellowship to the Peter MacCallum Cancer Centre in Melbourne, he has built his practice around complex colorectal surgery, with robotic-assisted technique as his primary surgical platform for colectomy and anterior resection.
Patients consult Dr. Sulaiman for his depth of experience in colorectal cancer and perianal conditions, as well as for consultations that are thorough, unhurried, and focused on giving patients a clear understanding of their options.
Credentials & Fellowship Training
Dr. Sulaiman holds an MBChB from the University of Sheffield, a Master of Medicine in Surgery (M.Med), and a Fellowship of the Royal Colleges of Surgeons of Edinburgh in General Surgery (FRCSEd). He completed a Ministry of Health Fellowship at the Peter MacCallum Cancer Centre in Melbourne, one of the world’s foremost oncology institutions, serves as a Visiting Consultant at Changi General Hospital and has contributed eight peer-reviewed publications to medical literature.
Former Director of Endoscopy, Changi General Hospital
Dr. Sulaiman served as Director of Endoscopy at Changi General Hospital, overseeing one of Singapore’s busiest endoscopy units, and brings that public-sector depth of experience to his private practice. In this role, he led a high-volume diagnostic endoscopy service encompassing colonoscopy and gastroscopy across a broad and diverse patient population.
Academic Appointments & Teaching Awards
Dr. Sulaiman holds concurrent Adjunct Associate Professor appointments at the NUS Yong Loo Lin School of Medicine, Lee Kong Chian School of Medicine, and Duke-NUS Medical School. He has been recognised on the Dean’s Honour Roll for Teaching and received the Singapore Health Quality Service Star Award 2023, reflecting his contribution to both surgical education and clinical care.
Contact Dr Sulaiman: Colorectal and General Surgeon in Singapore
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Frequently Asked Questions
How is Meckel’s diverticulum different from other types of diverticula?
Unlike other diverticula, which are usually acquired with age and occur in the colon, Meckel’s diverticulum is congenital (present from birth) and occurs in the small intestine.
Is there a risk of Meckel’s diverticulum recurring after it’s removed?
Once removed, Meckel’s diverticulum does not recur. However, any ongoing symptoms after surgery should be evaluated to ensure no other digestive issues are present.
Can Meckel’s diverticulum be managed by lifestyle changes alone?
Since it is a congenital condition, lifestyle changes alone cannot prevent Meckel’s diverticulum or its complications. However, being aware of symptoms and seeking timely medical advice is beneficial.