Skip to main contentMeckel's diverticulum and adult intussusception treatment in Ahmedabad and Gandhinagar · Dr Harsh Shah · Intestine Surgeon · Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
In an adult, intussusception — one part of the intestine telescoping into the next — almost always has a cause, called a lead point, and a proportion of those causes are tumours. So an adult with symptomatic intussusception has the affected segment removed without first pushing it back, unlike a child. A Meckel’s diverticulum, a small pouch on the lower small intestine present from birth, is silent in most people for life; when it bleeds, blocks or becomes inflamed, it is removed, and a bleeding one is removed with the adjoining segment of bowel. Two situations do not need surgery: a short, passing intussusception seen by chance on a CT with no cause and no symptoms, which is watched, and some Meckel’s diverticula found by chance during another operation.
Dr. Jivraj Mehta Hospital
Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Intestine Surgeon
· Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Dr Harsh Shah has 18 years of experience in surgery of the intestine, qualified twice over in surgical gastroenterology. These conditions are found through several doors — the emergency department, a bleeding work-up, or an appendix operation that finds a normal appendix — and at Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad each door leads to the same team: CT and CT angiography, the nuclear medicine Meckel scan, capsule endoscopy and enteroscopy, laparoscopic and open surgery, pathology that reports every removed segment, and genetics when a polyp syndrome is found. Google rating 4.94 from 18 reviews at the Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad listing.
Meckel's diverticulum and adult intussusception are considered together because a Meckel's diverticulum is a classic cause of intussusception in adults, and both tend to show up as unexplained bleeding or a blockage in a younger adult. The single most important difference from children is this: in a child, intussusception is usually without a cause and is pushed back with an enema; in an adult it usually has a cause, and is treated by removal.
Meckel’s diverticulum is a small finger-like pouch on the last part of the small intestine (the ileum), left over from development before birth. A minority of people have one and most never find out. It can contain patches of stomach-type lining that make acid, which ulcerates the neighbouring bowel and bleeds; it can be tethered by a fibrous band that twists or traps bowel; it can become inflamed exactly like an appendix; and rarely a small tumour grows in it.
Intussusception in an adult usually comes on as repeated or partial blockage — colicky pain that comes and goes, bloating, vomiting, sometimes a lump that can be felt. The “redcurrant jelly” stool described in children is uncommon in adults. Because something is usually pulling the bowel inwards, finding that “something” is the centre of the work-up.
The first test depends on how the problem shows itself. For a blockage or pain, a contrast CT of the abdomen is the key test: it shows the typical "target" or "sausage" appearance of intussusception and, just as importantly, looks for the lead point. For bleeding without an obvious source, a Meckel scan, CT angiography during active bleeding, and capsule endoscopy or enteroscopy are used in turn.
| Presentation | Test, in order | What it answers |
|---|---|---|
| Colicky pain, vomiting, bloating | Contrast CT of the abdomen | Is there an intussusception or a blockage, how long a segment, is the bowel’s blood supply at risk, and what is the lead point — a polyp, a fatty lump, a Meckel’s diverticulum, or a growth |
| Bleeding from the bowel with a normal upper endoscopy and colonoscopy | Technetium (Meckel) scan, especially in younger patients | Picks up the stomach-type lining inside a Meckel’s diverticulum. A negative scan does not rule one out |
| Bleeding that is active at the time of testing | CT angiography | Shows where blood is leaking into the bowel |
| Bleeding that stops and starts, once blockage is excluded | Capsule endoscopy, or enteroscopy with a long endoscope | Looks along the whole small intestine for an ulcer, polyp or diverticulum |
| Pain like appendicitis, with a normal appendix at operation | The surgeon runs the whole small intestine | This is where most adult Meckel’s diverticula are found — inflamed and mistaken for appendicitis |
Blood tests show whether there is anaemia from slow bleeding, and the CT also shows whether there are other polyps along the bowel — a clue to an inherited polyp syndrome.
In adults, the cause pulling the bowel inwards may be benign — a fatty lump (lipoma), a polyp, a Meckel's diverticulum, a Peutz-Jeghers polyp or an inflammatory polyp — or malignant, such as a cancer, a lymphoma, a GIST or a deposit from a melanoma elsewhere. A cancerous lead point is commoner when the intussusception involves the large bowel than when it is confined to the small bowel. That is why the segment is removed whole and examined, not pushed back.
| Lead point | Typical clues | What it means for the operation |
|---|---|---|
| Lipoma, polyp, Meckel’s diverticulum, inflammatory polyp | Small-bowel intussusception, a smooth fatty or polyp-like lump on CT | A short segmental removal; limited reduction to shorten the resection only if the cause is confidently benign and the bowel is healthy |
| Several polyps along the small bowel | Several polyps on CT, or a family history of polyps | Peutz-Jeghers syndrome is suspected — bowel is conserved and every polyp is cleared at one sitting using an endoscope during the operation; genetics referral |
| A growth — cancer, lymphoma, GIST or a melanoma deposit | Large-bowel involvement, an irregular mass, weight loss, enlarged nodes | Removal without reduction, with the lymph nodes as a cancer operation; the patient then moves to the relevant cancer pathway |
| No lead point | Short, passing, small-bowel segment seen by chance, no symptoms, no blockage | No operation — a repeat look to confirm that it has resolved |
Pushing back an intussusception caused by a tumour can tear the bowel, spill tumour cells, and squeeze them into the veins. That is the reason behind the rule this service keeps without exception in adults: an intussusception with a suspected cause is removed, not reduced.
The treatment is matched to what is found. A passing intussusception without a cause is watched. A bleeding patient is first stabilised and the anaemia corrected. A symptomatic Meckel's diverticulum is removed, with the neighbouring bowel if it bled. An intussusception with a lead point is removed in one piece without reduction, and when the large bowel is involved or the cause looks malignant, the removal is done as a cancer operation with its lymph nodes.
| Situation | Treatment | Why |
|---|---|---|
| Short, passing small-bowel intussusception on CT, no cause, no symptoms | Observation and a repeat scan | A common chance finding that usually settles; operating on it is over-treatment |
| Bleeding Meckel’s diverticulum | Resuscitation and transfusion if needed, then removal of the diverticulum with the adjoining segment of ileum | The bleeding ulcer sits in the neighbouring ileum, not in the pouch — removing the pouch alone leaves the ulcer behind |
| Inflamed or perforated Meckel’s with a narrow base and healthy neighbouring bowel | Removal of the diverticulum alone (a wedge) | Enough when the base is narrow; a segment is removed if the base is broad or the ileum inflamed |
| Meckel’s band causing a blockage | The band is divided and the diverticulum removed | Removes the cause of the twist or trap |
| Small-bowel intussusception with a lead point | Removal of the segment in one piece without reduction | The lead point is examined fully; reduction risks spreading a tumour |
| Large-bowel or ileocolic intussusception | A cancer-standard removal — for ileocolic, a right hemicolectomy — without reduction | A malignant cause is common enough that this is the default |
An operation is not needed for a Meckel's diverticulum that never causes trouble, for a short, passing intussusception seen by chance on a CT without a cause or symptoms, and — after a careful judgment — for some Meckel's diverticula found incidentally during another operation, especially in older patients or when the abdomen is infected.
Short intussusceptions of the small bowel that come and go are now a frequent chance finding on CT scans done for unrelated reasons. They are distinguished from true intussusception by being brief, short, not blocking the bowel and having no lead point. Operating on these is a genuine harm, and the right step is to confirm that the finding has resolved.
The incidental Meckel’s diverticulum is honestly debated, because no international guideline settles it. The lifetime chance of it causing trouble is small and falls with age, while removing it adds a join in the bowel. The approach followed here is a documented judgment:
Either way, its presence, size and appearance, and the reason for the decision, are written in the operation note and the discharge summary — so that any future doctor investigating unexplained bleeding knows it is there.
Most of these operations can be done by laparoscopy, which is also how the diagnosis is often confirmed, with the bowel brought out through a small incision to be removed and rejoined. The whole small intestine is examined from end to end, everything removed is sent for histology, and as much bowel length as possible is preserved.
Laparoscopy lets the surgeon look at the whole abdomen, find the diverticulum or the telescoped segment, and bring that loop out through a small extraction incision so that the removal and join are made outside the abdomen. The entire small intestine is run, because more than one lesion can be present, particularly in Peutz-Jeghers syndrome. When the large bowel is involved, the removal follows cancer principles, including the lymph nodes, and the site for a possible stoma is marked before surgery.
Recovery follows an enhanced-recovery pathway: out of bed and sipping clear fluids on the day of surgery, eating and walking the next day, and home within a few days once eating, comfortable and passing wind or stool.
The complications every patient hears about before agreeing: bleeding needing transfusion; wound infection; clots in the legs or lungs; anaesthetic complications; conversion from laparoscopic to open surgery; a leak from the join in the bowel; a collection of pus in the abdomen; a slow return of bowel function; adhesions causing a blockage later in life; a hernia at the wound; and, uncommonly, a stoma if the bowel is unhealthy or the abdomen contaminated. After removal of a long piece of ileum, loose stools from bile salts can occur and are treatable, and vitamin B12 injections may be needed long term. And a risk to life, which is low in a fit adult and higher with perforation, peritonitis or heavy bleeding. Dr Harsh Shah goes through each of these personally before consent, with the figures that apply to your operation and your health — they are not general numbers and are not quoted on a page.
Every removed segment is examined under the microscope, and the report is reviewed by a named person and discussed with you at the follow-up visit. A benign cause completely removed needs no long-term follow-up. A malignant lead point moves straight to the relevant cancer pathway for staging and further treatment. A polyp syndrome leads to lifelong surveillance and testing of relatives.
The histology is the part that must never be left unread, because a malignant lead point changes everything that follows. Where Peutz-Jeghers syndrome or another polyp syndrome is identified, the patient enters lifelong surveillance and family members are offered testing. After a significant length of ileum has been removed, vitamin B12 and iron are monitored. Where a Meckel’s diverticulum was found and left in place, that is recorded in the discharge summary.
A patient describes recovery after laparoscopic release of a small-bowel blockage caused by adhesions, with Dr Harsh Shah. It is shared to show the recovery after small-bowel surgery at this centre; it is not a Meckel’s or intussusception patient’s account.
Surgery for Meckel's diverticulum and intussusception is covered by cashless health insurance and by corporate schemes at Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad, subject to the policy's terms. What moves an estimate is whether it is an emergency or planned admission, laparoscopic or open surgery, the length of bowel removed, transfusion, and the length of stay. A written estimate is prepared for your own policy rather than a figure being quoted in general.
For a planned operation, pre-authorisation is arranged with a note from Dr Harsh Shah’s office. Bring policy papers, identification and every report.
★★★★★
★★★★★
“I would like to recommend Dr Swati and Dr Harsh for any gastrointestinal and uro- gynecological related issues..Both doctors are highly experienced and treat patients with utmost care. — Neha Jain, Google review”
★★★★★
“I am very thankful to Dr. Harsh Shah for treating me for gallstone disease and performing my laparoscopic cholecystectomy. The entire treatment and surgery were handled very professionally. Dr. Harsh Shah explained everything clearly and made me feel comfortable throughout the process. My recovery has been very good, and I am extremely satisfied with the care I received. Highly recommended for laparoscopic and gastrointestinal surgery. — Akshaya Shaw, Google review”
Real Google reviews from Dr Harsh Shah’s two listings, reproduced exactly as written.
In children, intussusception usually has no cause and pushing it back with an enema is the right treatment. In adults there is usually a cause pulling the bowel inwards, and sometimes it is a tumour, so the segment is removed and examined instead of being pushed back.
Often not. A short, passing intussusception of the small bowel with no cause, no blockage and no symptoms is a common chance finding. It is watched and rechecked rather than operated on. The CT is reviewed for a lead point before that decision.
It is a small pouch on the lower small intestine present from birth. Most people never know they have one. It matters when it bleeds, causes a blockage, becomes inflamed or perforates — then it is removed.
The bleeding comes from an ulcer in the bowel next to the pouch, caused by acid from stomach-type lining inside it. Removing only the pouch can leave the ulcer behind, and the bleeding can return.
Not necessarily. Leaving an incidental Meckel's is reasonable in some situations, such as an infected abdomen or an older patient. What matters is that it was recorded, so it can be considered if you ever have unexplained bleeding.
Yes. Every removed segment is examined under the microscope, and the report is reviewed and discussed with you at follow-up. If a cancer is found, further treatment is planned on the relevant cancer pathway.
Dr Harsh Shah consults at Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad.
Patients come to Dr Harsh Shah from across Gujarat and from Rajasthan and Madhya Pradesh. The work-up, the operation and the histology review happen here; for a benign cause, follow-up afterwards is brief.
Repeated bouts of colicky pain, unexplained bleeding, or a CT that mentions "intussusception"? The CT, any capsule endoscopy or Meckel scan report, and blood reports can be sent ahead of the appointment so the consultation starts with them already read; the treatment itself is decided at the consultation, after examination. Call +91-63555-64601 · Send the reports ahead on WhatsApp
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