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Pancreas transplant and incidental Meckel's diverticulum: not always a straightforward decision
Timothy D Light1, Jimmy A Light
1Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1009, USA. timothy-light@uiowa.edu
Introduction:
Unexpected intraoperative findings are not rare in surgical practice. Meckel's diverticulum with a mass is one such example. There are only two previously reported cases of Meckel's in transplantation, and neither involved pancreas transplant.
Results And Discussion:
We present a case report of novel surgical technique using a Meckel's diverticulectomy site for the duodeno-enterostomy to managing the exocrine secretions of the transplanted pancreas. We also discuss management of Meckel's diverticulum. The patient tolerated the procedure without complication, and continues to have normal renal and pancreatic function without any gastrointestinal (GI) complaints. The excised Meckel's diverticulum contained both gastric and pancreatic tissue.
Conclusion:
Although uncertainty about the best management practices exists in the general surgery patient population, given the potential complications that may arise from Meckel's diverticulum, in transplant patients the Meckel's should be removed when encountered. The point of excision can safely be incorporated into other intestinal anastomoses.
Insights
This case report details a novel surgical technique for pancreas transplant patients with Meckel's diverticulum. The Meckel's diverticulectomy site was used for duodeno-enterostomy, managing exocrine secretions safely.
Area of Science:
- Surgical Innovation
- Transplant Surgery
- Gastrointestinal Surgery
Background:
- Unexpected intraoperative findings, such as Meckel's diverticulum with a mass, occur in surgery.
- Meckel's diverticulum is rare in transplantation, with no prior cases involving pancreas transplant.
- Management of Meckel's diverticulum in transplant recipients requires careful consideration.
Observation:
- A case of Meckel's diverticulum encountered during pancreas transplantation is presented.
- The Meckel's diverticulum contained both gastric and pancreatic tissue.
- A novel surgical technique utilized the Meckel's diverticulectomy site for duodeno-enterostomy.
Findings:
- The novel technique successfully managed exocrine secretions from the transplanted pancreas.
- The patient experienced no complications and maintained normal renal and pancreatic function.
- The excised Meckel's diverticulum was safely incorporated into the intestinal anastomosis.
Implications:
- Meckel's diverticulum should be removed if encountered in pancreas transplant patients.
- Excision of Meckel's diverticulum can be safely integrated into other intestinal anastomoses.
- This technique offers a safe and effective approach for managing Meckel's diverticulum in pancreas transplantation.
