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.

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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 doctor 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 Yusof is a distinguished Senior Consultant in colorectal and general surgery, boasting over 15 years of expertise. His passion lies in minimally invasive techniques, particularly robotic surgery, where he has achieved remarkable success using the Da Vinci Xi system. Dr. Sulaiman is dedicated to delivering high-quality, personalized, and empathetic care, always striving for the best outcomes for his patients.

Education & Specialist Training
  • MbChB(Sheffield)
  • M.Med(Surgery)
  • FRCSEd(General Surgery)

Dr. Sulaiman’s journey began at the University of Sheffield, where he graduated in 2002. He honed his skills during his house officer and basic surgical training in the UK before returning to Singapore. There, he completed his Advanced Surgical Training at Changi General Hospital and earned the Joint Speciality Fellowship in General Surgery in 2013.

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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.

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