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Laparoscopic Meckel's diverticulectomy in infants: report of three cases
Abstract:
Three infants younger than 2 years presented with episodic bloody-to-tarry stool of moderate amount. Two of them were diagnosed to have Meckel's diverticulum because of a positive 99mTc pertechnetate scan. Although the third infant had two negative radionuclide scans within 3 months, Meckel's diverticulum was still suspected by exclusion studies. All three infants underwent laparoscopic surgery. At laparoscopy, a Meckel's diverticulum was identified in all. Besides, an ileoileo intussusception just proximal to the diverticulum was also found in one patient. Reduction of the intussusception and diverticulectomy were performed successfully by laparoscopic procedure. Compared with conventional laparotomy, this procedure has the advantages of direct preoperative visual confirmation of the diagnosis, less traumatic access, much shorter recovery period and perhaps fewer intraoperative and postoperative complications. And thus, laparoscopic surgery has the potential of becoming regular treatment for symptomatic Meckel's diverticulum of infants.
Insights
Laparoscopic surgery successfully treated symptomatic Meckel
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- Meckel's diverticulum is a congenital anomaly that can cause gastrointestinal bleeding in infants.
- Diagnosis can be challenging, especially with negative initial imaging.
- Surgical intervention is often required for symptomatic cases.
Observation:
- Three infants under two years old presented with recurrent bloody or tarry stools.
- Two infants were diagnosed via technetium-99m pertechnetate scans; the third was diagnosed by exclusion.
- All infants underwent laparoscopic surgery.
Findings:
- Laparoscopy confirmed Meckel's diverticulum in all three infants.
- One infant also had an ileoileal intussusception proximal to the diverticulum.
- Laparoscopic diverticulectomy and intussusception reduction were performed successfully.
Implications:
- Laparoscopic surgery offers advantages over laparotomy for infant Meckel's diverticulum, including less trauma and faster recovery.
- This minimally invasive approach may become the standard treatment for symptomatic Meckel's diverticulum in infants.
- Early diagnosis and surgical management are crucial for favorable outcomes.
