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][1][2][3][1][4]
Asymptomatic Meckel’s diverticulum
An asymptomatic Meckel diverticulum is discovered incidentally on abdominal imaging or exploration( laparoscopy or laparotomy) for another indication such as a presumptive diagnosis of acute cholecystitis.
Usually, surgical resection is avoided in cases of asymptomatic diverticula because in order to benefit a single patient, 800 incidental diverticula need to be removed.
In elderly patients, resection of diverticulum may be performed to prevent complications
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, inflammed diverticulum
Children
Elderly patients
Removal of an asymptomatic diverticulum is not advised in the presence of complications such as:
ulcerative colitis
Crohn disease
Peritonitis
Surgery
References
- ↑ 1.0 1.1 1.2 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.