Meckel diverticulum: ten-year experience in adults

Area of Science:

• Gastroenterology
• Surgical Pathology
• Adult Surgery

Background:

• Meckel diverticulum is a common congenital anomaly but is less frequently diagnosed and studied in adults compared to children.
• Surgical management at Charleston Area Medical Center (CAMC) includes removal of incidentally found Meckel diverticula, in addition to symptomatic cases.

Purpose of the Study:

• To review the experience with Meckel diverticulum in adult patients over a ten-year period at CAMC.
• To analyze the demographics, indications for removal, pathological findings, and perioperative complications associated with adult Meckel diverticula.

Main Methods:

• A retrospective review of 47 adult patients (age > 18) who underwent Meckel diverticulum removal between 1992 and 2002.
• Data collected included patient age, sex, reason for diverticulum removal, pathological results, and any complications during the perioperative period.

Main Results:

• Meckel diverticula were more frequently removed from females (66%).
• Incidental removal occurred in 74.5% of cases, while 25.5% were symptomatic (obstruction, bleeding, diverticulitis).
• Symptomatic presentation was significantly more common in males (50%) than females (13%). Heterotopic gastric mucosa was found in 6 patients; one asymptomatic patient had a carcinoid tumor. Overall morbidity was 8.5% (wound infections, anastomotic leaks), with no mortalities.

Conclusions:

• Meckel diverticulum is an infrequent finding in adults, with a low rate of symptomatic presentation.
• Symptomatic adult Meckel diverticula are associated with considerable morbidity, and surgical complications, though uncommon, can be life-threatening.
• Routine, incidental surgical removal of asymptomatic Meckel diverticula is not recommended, particularly in female patients.