Laparoscopic diverticulectomy or laparoscopic-assisted resection of symptomatic Meckel diverticulum in children? A systematic review

Redman, Elizabeth P; Mishra, Prabal; Stringer, Mark D.

doi:10.1007/s00383-020-04673-5

Cited by 10 publications

(5 citation statements)

References 18 publications

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“…Surgical resection is the mainstay treatment for patients with complicated MD 30,31 . Laparoscopy or laparoscopy‐assisted approach method has become a safe and effective method for treating complicated MD compared with the traditional open approach 32 . In our present study, we found that 85.7% of all our patients with MD underwent surgical treatment, including laparoscopy (75%), laparotomy (16.7%), and laparoscopy converter to laparotomy (8.3%).…”

Section: Discussionmentioning

confidence: 63%

Meckel's diverticulum diagnosed by double‐balloon enteroscopy: A single‐center retrospective study in Taiwan

Chang

Chou

et al. 2021

JGH Open

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Background and Aim Meckel's diverticulum (MD) is a common congenital abnormality of the gastrointestinal (GI) tract. Although a few patients with MD present symptoms, preoperative diagnosis of MD is a clinical challenge because of its endoscopic inaccessibility. The aim of the present study was to investigate patients with MD diagnosed by double‐balloon enteroscopy (DBE) in Taiwan. Methods We conducted a retrospective study in a tertiary referral center in middle Taiwan. The clinical characteristics, endoscopic features, histopathological findings, treatment methods, and outcomes of patients with MD diagnosed by DBE were analyzed. Results A total of 14 male patients with MD diagnosed by DBE were enrolled. The mean age of all patients was 32.3 years. GI bleeding (78.6%) accounted for the major indication of DBE, followed by abdominal pain and Crohn's disease follow‐up. The mean distance between the ileocecal valve and MD was 68.9 cm. The average length of 12 patients with surgically resected MD was 5.2 cm. The diagnostic yields of the other modalities excepting DBE are as follows: capsule endoscopy, 50%; Meckel's scan, 11.1%; computed tomography, 16.7%; small bowel series, 0%; and angiography, 33.3%. MD presented as a large ostium in 13 patients (92.9%), a small ostium in 1 patient (7.1%), and bleeding signs in 10 patients (71.4%). Twelve patients (85.7%) underwent surgical treatment and 2 patients (14.3%) received conservative treatment. Heterotopic gastric tissue was identified in 4 patients (28.6%). Conclusion The present study showed that DBE is a more powerful modality in detecting MD than the other conventional modalities in Taiwan.

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Section: Discussionmentioning

confidence: 63%

Meckel's diverticulum diagnosed by double‐balloon enteroscopy: A single‐center retrospective study in Taiwan

Chang

Chou

et al. 2021

JGH Open

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“…The typical cause of bleeding in Meckel’s diverticulum is ulceration of the adjacent ileal mucosa due to acid secretion from heterotopic gastric tissue 7. Therefore, a simple diverticulectomy without resection of the adjacent ulcerated ileal tissue may not effectively stop the bleeding in a broad-based Meckel’s diverticulum, and segmental resection may be required 8. In this case, the proximity to the ileocaecal valve raised concerns about potential stricture or leakage of the staple line from downstream pressurisation by the ileocaecal valve, and therefore, an ileocaecectomy was the procedure of choice.…”

Section: Discussionmentioning

confidence: 99%

Occult bleeding from a false-in-true non-Meckelian ileal diverticulum

Vacharathit,

Siranart,

Prueksapanich

et al. 2024

BMJ Case Rep

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Ileal diverticula can be congenital or acquired and are rare even among the already rare entity of small bowel diverticula. What has never been reported, as far as we know, is false diverticula arising within the true non-Meckelian diverticulum with mesenteric erosion causing an occult gastrointestinal bleed. We present a patient with occult gastrointestinal bleeding from a false-in-true ileal diverticulum. Multiple investigations were required to localise the bleeding site after which the patient was taken to the operating room for a laparoscopic ileocaecectomy with complete resolution of symptoms. Preoperative localisation of the bleeding site may be difficult but is critically important in occult gastrointestinal bleeding. Procedure choice for a bleeding ileal diverticulum is dictated by the distance from the ileocaecal valve and the etiopathology of the bleed.

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“…Conventionally, surgery has been the mainstay treatment for patients with complicated Meckel's diverticulum [ 38 , 39 ]. Laparoscopy or laparoscopy-assisted treatment is a recognized safe and effective method for treating complicated Meckel's diverticulum compared with the alternative open approach [ 40 , 41 ]. Our results showed that 76.4% of all patients with Meckel's diverticulum underwent surgical treatment, including laparoscopy (66.7%), laparotomy (30.9%), and laparoscopy converted to laparotomy (2.4%).…”

Section: Discussionmentioning

confidence: 99%

Meckel’s Diverticulum Diagnosed by Balloon-Assisted Enteroscopy: A Multicenter Report from the Taiwan Association for the Study of Small Intestinal Diseases (TASSID)

Chou

Chung

Huang

et al. 2021

Gastroenterology Research and Practice

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Background and Aims. Patients with Meckel’s diverticulum (MD) are difficult to preoperatively diagnose because of its endoscopic inaccessibility. Balloon-assisted enteroscopy (BAE) allows endoscopic access to the entire small intestine. The aim of the current study was to investigate patients with MD diagnosed by BAE in Taiwan. Methods. We conducted a retrospective, multicenter study of patients with MD who were diagnosed by BAE in Taiwan. The clinical characteristics, endoscopic features, histopathological findings, treatment methods, and outcomes were analyzed. Results. A total of 55 patients with MD were enrolled (46 males and 9 females). The mean age at diagnosis was 34.1 years. Overt gastrointestinal bleeding (87.3%) was the primary indication for BAE, followed by abdominal pain (9.1%), suspected small bowel tumor (1.8%), and Crohn’s disease follow-up (1.8%). The mean distance between the ileocecal valve and MD was 71.6 cm (regarding diagnostic yields: BAE—100%, capsule endoscopy—40%, Meckel’s scan—35.7%, computed tomography—14.6%, small bowel series—12.5%, and angiography—11.1%; regarding endoscopic features of MD: a large ostium—89.1%, a small ostium—7.3%, and a polypoid mass—3.6%). Surgical treatment was performed in 76.4% patients, and conservative treatment was performed in 23.6% patients. The mean length of MD in 42 patients who underwent surgical resection was 5.2 cm (in 43 patients of MD with available histopathology: heterotopic gastric tissue, 42.4%, heterotopic gastric and pancreatic tissues, 7%; heterotopic pancreatic tissue, 4.7%; heterotopic colonic tissue, 2.3%; and a neuroendocrine tumor, 2.3%). Conclusions. The current study showed BAE is a very useful modality for detecting MD compared with other conventional modalities.

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Laparoscopic diverticulectomy or laparoscopic-assisted resection of symptomatic Meckel diverticulum in children? A systematic review

Cited by 10 publications

References 18 publications

Meckel's diverticulum diagnosed by double‐balloon enteroscopy: A single‐center retrospective study in Taiwan

Meckel's diverticulum diagnosed by double‐balloon enteroscopy: A single‐center retrospective study in Taiwan

Occult bleeding from a false-in-true non-Meckelian ileal diverticulum

Meckel’s Diverticulum Diagnosed by Balloon-Assisted Enteroscopy: A Multicenter Report from the Taiwan Association for the Study of Small Intestinal Diseases (TASSID)

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