Meckel's diverticulum surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]

Overview

Surgery is the primary treatment modality in patients with Meckel's diverticula. Asymptomatic patients are treated in the presence of features such as narrow diverticular mouth, fibrous bands, ectopic gastric tissue, diverticular length >2cm, stasis, narrow neck, intramural pathology, thickening and inflammation of the diverticulum. On the other hand, absolute indications for resection of a symptomatic Meckel's diverticulum include complications such as hemorrhage, umbilico ileal fistulas, diverticulitis and bowel obstructionFibrous band division, diverticulectomy, segmental resection of the diverticulum with end-to-end intestinal anastomosis and wedge resection are the various surgical procedures performed, whenever indicated.

Surgery

Asymptomatic Meckel’s diverticulum

Symptomatic Meckel diverticulum

References

  1. 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. PMID 18216533. doi:10.1097/SLA.0b013e31815aaaf8. 
  2. 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 1356994Freely accessible. PMID 15729078. 
  3. 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. 
  4. 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. PMID 28359587. doi:10.1016/j.jpedsurg.2017.03.047. 
  5. Soltero MJ, Bill AH (1976). "The natural history of Meckel's Diverticulum and its relation to incidental removal. A study of 202 cases of diseased Meckel's Diverticulum found in King County, Washington, over a fifteen year period". Am. J. Surg. 132 (2): 168–73. PMID 952346. 
  6. Thirunavukarasu P, Sathaiah M, Sukumar S, Bartels CJ, Zeh H, Lee KK, Bartlett DL (2011). "Meckel's diverticulum--a high-risk region for malignancy in the ileum. Insights from a population-based epidemiological study and implications in surgical management". Ann. Surg. 253 (2): 223–30. PMC 4129548Freely accessible. PMID 21135700. doi:10.1097/SLA.0b013e3181ef488d. 
  7. Cullen JJ, Kelly KA, Moir CR, Hodge DO, Zinsmeister AR, Melton LJ (1994). "Surgical management of Meckel's diverticulum. An epidemiologic, population-based study". Ann. Surg. 220 (4): 564–8; discussion 568–9. PMC 1234434Freely accessible. PMID 7944666. 
  8. Gezer HÖ, Temiz A, İnce E, Ezer SS, Hasbay B, Hiçsönmez A (2016). "Meckel diverticulum in children: Evaluation of macroscopic appearance for guidance in subsequent surgery". J. Pediatr. Surg. 51 (7): 1177–80. PMID 26435520. doi:10.1016/j.jpedsurg.2015.08.066. 
  9. McKay R (2007). "High incidence of symptomatic Meckel's diverticulum in patients less than fifty years of age: an indication for resection". Am Surg. 73 (3): 271–5. PMID 17375785. 
  10. Hosn MA, Lakis M, Faraj W, Khoury G, Diba S (2014). "Laparoscopic approach to symptomatic meckel diverticulum in adults". JSLS. 18 (4). PMC 4254485Freely accessible. PMID 25489221. doi:10.4293/JSLS.2014.00349. 
  11. Alemayehu H, Stringel G, Lo IJ, Golden J, Pandya S, McBride W, Muensterer O (2014). "Laparoscopy and complicated meckel diverticulum in children". JSLS. 18 (3). PMC 4208888Freely accessible. PMID 25392652. doi:10.4293/JSLS.2014.00015. 
  12. Ruscher KA, Fisher JN, Hughes CD, Neff S, Lerer TJ, Hight DW, Bourque MD, Campbell BT (2011). "National trends in the surgical management of Meckel's diverticulum". J. Pediatr. Surg. 46 (5): 893–6. PMID 21616248. doi:10.1016/j.jpedsurg.2011.02.024. 
  13. Chan KW, Lee KH, Mou JW, Cheung ST, Tam YH (2008). "Laparoscopic management of complicated Meckel's diverticulum in children: a 10-year review". Surg Endosc. 22 (6): 1509–12. PMID 18322735. doi:10.1007/s00464-008-9832-0. 



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