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Does an Incidental Meckel's Diverticulum Warrant Resection?

Shermeen Rahmat1, Prerna Sangle1, Osama Sandhu1

  • 1Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.

Cureus
|September 14, 2020
PubMed
Summary

Management of incidental Meckel

Keywords:
incidental meckel's diverticulumresection

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Area of Science:

  • Gastroenterology
  • Surgical Management
  • Medical Literature Review

Background:

  • Meckel's diverticulum (MD) is the most frequent congenital anomaly of the gastrointestinal tract.
  • Symptomatic Meckel's diverticulum management involves resection, but incidental Meckel's diverticulum management remains debated.
  • The optimal surgical approach for incidental Meckel's diverticulum requires further clarification.

Purpose of the Study:

  • To systematically review current literature regarding the surgical management of incidental Meckel's diverticulum.
  • To analyze recommendations for resection versus non-resection of incidental Meckel's diverticulum.
  • To identify trends and knowledge gaps in the management of incidental Meckel's diverticulum.

Main Methods:

  • Systematic literature review utilizing PubMed, PubMed Central (PMC), and MEDLINE databases.
  • Search terms included "Meckel Diverticulum/Surgery [Mesh]" and "resection incidental".
  • Studies published between 1980 and July 18, 2020, were assessed for quality and recommendations.

Main Results:

  • Initial search yielded 62 articles; 31 studies met inclusion criteria after screening.
  • Recommendations varied: 4 studies advised no resection, 12 recommended resection, 10 suggested resection with risk factors, and 5 offered no clear guidance.
  • Recent literature indicates a trend towards resection for all or high-risk incidental Meckel's diverticulum cases.

Conclusions:

  • The management of incidental Meckel's diverticulum lacks definitive consensus.
  • A shift towards resection, either universally or in high-risk individuals, is observed in recent literature.
  • Further research is needed to establish evidence-based guidelines for risk factors and determine optimal management strategies for incidental Meckel's diverticulum.