Meckel's diverticulum in the adult

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Meckel's diverticulum (MD) is the most common congenital gastrointestinal malformation, affecting approximately 2% of the population.
• Complications, including bleeding, obstruction, and inflammation, occur in an estimated 4% of individuals over their lifetime.
• Diagnosis of MD is challenging, often requiring exploratory laparoscopy, and is frequently incidental in adults due to decreasing complication risk with age.

Purpose of the Study:

• To review the diagnostic challenges and management strategies for Meckel's diverticulum.
• To evaluate the indications for surgical resection versus conservative management of incidentally discovered MD.
• To compare surgical techniques for MD resection, focusing on minimizing recurrence and complications.

Main Methods:

• Literature review of large series analyzing Meckel's diverticulum cases.
• Analysis of risk factors associated with symptomatic Meckel's diverticulum.
• Evaluation of surgical outcomes based on resection techniques.

Main Results:

• Surgical resection is indicated for symptomatic Meckel's diverticulum.
• Surgery for incidental MD is debated; risk factors for complications include male gender, age <40, diverticulum >2cm, and mucosal abnormalities.
• Resection with anastomosis is preferred over wedge or tangential resection to avoid leaving heterotopic mucosa.

Conclusions:

• Management of Meckel's diverticulum requires careful consideration of symptoms and risk factors.
• Surgical intervention for incidental Meckel's diverticulum should be individualized based on identified risk factors.
• Anastomotic resection is the preferred surgical technique for Meckel's diverticulum to prevent complications related to heterotopic mucosa.