Meckel's diverticulum surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Surgical treatment consists of a resection of the affected portion of the bowel.[1][2][3][4]
Asymptomatic Meckel’s diverticulum
- An asymptomatic Meckel's diverticulum is discovered incidentally on abdominal imaging or exploration( laparoscopy or laparotomy) for an indication such as a presumptive diagnosis of acute cholecystitis.
- Generally, surgical resection is avoided in cases of asymptomatic diverticula as in order to benefit a single patient, 800 incidental diverticula need to be removed.
- In elderly patients, resection of diverticulum may be preferred to prevent complications.
- Removal of an asymptomatic diverticulum is not advised in the presence of complications such as:
- The decision regarding resection is made by the surgeon based on appearance of the diverticulum.
- Indications for resection include:
- Absence of a wide mouth
- Diverticula with fibrous bands
- Presence of ectopic gastric tissue
- Length of diverticulum more than 2cm
- Narrow neck of diverticulum may undergo twisting or obstruction
- Presence of intramural pathology
- Thickened, inflamed diverticulum
- Children
- Elderly patients
Symptomatic Meckel diverticulum
- Absolute indications for resection of a symptomatic Meckel's diverticulum include complications such as:
- Hemorrhage
- Umbilicoileal fistulas
- Inflammation of diverticulum: Diverticulitis
- Bowel obstruction
Surgery
References
- ↑ Zani A, Eaton S, Rees CM, Pierro A (2008). "Incidentally detected Meckel diverticulum: to resect or not to resect?". Ann. Surg. 247 (2): 276–81. doi:10.1097/SLA.0b013e31815aaaf8. PMID 18216533.
- ↑ Park JJ, Wolff BG, Tollefson MK, Walsh EE, Larson DR (2005). "Meckel diverticulum: the Mayo Clinic experience with 1476 patients (1950-2002)". Ann. Surg. 241 (3): 529–33. PMC 1356994. PMID 15729078.
- ↑ Lohsiriwat V, Sirivech T, Laohapensang M, Pongpaibul A (2014). "Comparative study on the characteristics of Meckel's diverticulum removal from asymptomatic and symptomatic patients: 18-year experience from Thailand's largest university hospital". J Med Assoc Thai. 97 (5): 506–12. PMID 25065089.
- ↑ Robinson JR, Correa H, Brinkman AS, Lovvorn HN (2017). "Optimizing surgical resection of the bleeding Meckel diverticulum in children". J. Pediatr. Surg. 52 (10): 1610–1615. doi:10.1016/j.jpedsurg.2017.03.047. PMID 28359587.