Related Experiment Videos
Surgical treatment of Meckel's diverticulum
1Department of Surgery, Saint Francis Medical Center, Trenton, NJ 08629.
Abstract:
Meckel's diverticula are the result of incomplete degeneration of the vitelline duct. It is generally believed that less than 5% of them become symptomatic, the frequency decreasing with age. Meckel's diverticula are most commonly manifested in children by painless lower gastrointestinal bleeding and in adults, as an inflammatory process or obstruction. Definitive diagnosis is usually made at surgery, though the Meckel's scan may suggest a diagnosis preoperatively, especially in the pediatric population. All symptomatic and pathologic Meckel's diverticula should be removed with a segment of ileum. The use of stapling devices, with their ease of use and low complication rate, make it reasonable to remove any Meckel's diverticulum that easily fits in the device. If a diverticulum found incidentally is so broad-based or short that stapling cannot be done without difficulty, it is unlikely to become symptomatic and should be left undisturbed.
Insights
Meckel
Area of Science:
- Gastroenterology
- Surgical Pathology
- Pediatric Surgery
Background:
- Meckel's diverticula arise from incomplete degeneration of the vitelline duct.
- Symptomatic presentation varies by age: common in children as painless lower GI bleeding, and in adults as inflammation or obstruction.
- Less than 5% of Meckel's diverticula become symptomatic, with prevalence decreasing with age.
Purpose of the Study:
- To review the presentation, diagnosis, and management of Meckel's diverticula.
- To provide guidance on the surgical resection of Meckel's diverticula, particularly concerning incidental findings.
Main Methods:
- Review of clinical manifestations and diagnostic approaches for Meckel's diverticula.
- Surgical management strategies, including the use of stapling devices, are discussed.
Main Results:
- Definitive diagnosis is often made intraoperatively.
- Meckel's scans can aid in preoperative diagnosis, especially in pediatric cases.
- Symptomatic and pathological diverticula require resection with a segment of ileum.
Conclusions:
- Resection of symptomatic or pathological Meckel's diverticula is recommended.
- Stapling devices facilitate the removal of suitable Meckel's diverticula due to ease of use and low complication rates.
- Incidental diverticula that are broad-based or short, making stapling difficult, are unlikely to become symptomatic and may be left undisturbed.