Meckel's diverticulum in the adult

Area of Science:

• Gastroenterology
• Surgical Research
• Clinical Epidemiology

Background:

• The management of incidentally detected Meckel's diverticulum (MD) in adults is debated.
• Complications from MD can arise in adult life, necessitating risk assessment.

Purpose of the Study:

• To evaluate the risks associated with the surgical excision of incidentally found Meckel's diverticula in adults.
• To determine the incidence of complications arising from Meckel's diverticulum during adult life.

Main Methods:

• Analysis of 260 adult cases of Meckel's diverticulum identified during laparotomy over 15 years.
• Categorization of diverticula into symptomatic and asymptomatic groups.
• Assessment of complication rates for both conservative management and surgical excision.

Main Results:

• Intestinal obstruction was the most frequent complication of symptomatic MD.
• The complication rate for adult MD was 0.03% per year, with a calculated lifetime risk of 3.7% at age 16.
• Surgical excision of incidentally found MD carried a 6% major complication rate, while non-excised asymptomatic cases showed no complications.

Conclusions:

• In adults, an incidentally discovered, asymptomatic Meckel's diverticulum should not be surgically removed.
• The risks of major complications from excision outweigh the potential risks of leaving asymptomatic MD in place in adults.