Surgical Management of Meckelʼs Diverticulum An Epidemiologic, Population-Based Study

Abstract

ObjectiveThe authors determined whether Meckel's diverticulum, discovered incidentally at operation, should be removed. Summary Background DataIt is not clear from the medical literature whether the risk of an incidental Meckel's diverticulectomy is greater than the risk of leaving the diverticulum in place. MethodsThe authors used the medical experience of Olmsted County, Minnesota residents for the period 1950 to 1992 to answer the question. ResultsDuring the period, 58 residents developed Meckel's complications that required diverticulectomies. The incidence of complications was 87 per 100,000 person-years, and the lifetime risk (to 80 years of age) of developing them was 6.4%. The risks were similar throughout the period and at all ages of life, but were greater among men (124 per 100,000 person-years) than women (50 per 100,000 person-years, p < 0.05). Diverticulectomies for complications carried an operative mortality and morbidity of 2% and 12% and a cumulative risk of long-term postoperative complications of 7%, whereas incidental diverticulectomies done in 87 residents during the period carried corresponding rates of only 1%, 2%, and 2%, respectively. ConclusionsMeckel's diverticula discovered incidentally at operation should be removed for most patients, regardless of age.Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract, affecting 2% of the general population.1 2 Although this prevalence fig-

Patent Vitellointestinal Duct with Inverted Ileal Loop Prolapse with Strangulation at Birth in Preterm (34 Weeks): A Rare Presentation

“…Failure to obliterate may lead to variety of congenital anomalies including; Meckel's diverticulum, vitelline cord, umbilical sinus, enteric fistula and or haemorrhagic umbilical mass [1][2][3][4]. To date only 15 cases have been reported in the English medical literature [5][6][7][8][9][10][11][12][13][14][15].…”

Perforation of Meckel's diverticulum with peritonitis: rare case report and review of literature

“…The mortality rate of these patients was 1.5%, with 7% morbidity; incidental removal had 1% mortality and 2% morbidity. 6 There are several studies stating the safe and effective use of laparoscopy in case of complicated Meckel's diverticulum. 15,16 It can be used in undiagnosed acute abdominal pain, in obstruction and perforation.…”

“…[3][4] A person with Meckel's diverticulum has a 4-6% lifetime risk of developing a complication 5 with a male to female ratio ranging from 1.8:1 to 3:1. 6 The most clinical presentation is GI bleeding in pediatric age group. Other complications include obstruction, intussusceptions and diverticulitis with perforation occurring rare in less than 7% of patients having complication.…”

Bleeding Meckel's Diverticulum in an Infant - A Case Report

“…A general rule of 2 is followed: present in 2 % popula on, 2 feet away from ileocaecal valve and 2 inches long although many anatomical varia ons exist. In many cases Meckel's diver culum is asymptoma c. Cullen et al reported in a popula on based study that the life me risk of developing a complica on of Meckel's diver culum was es mated to be 6.4% 3 . The complica ons like painless per rectal bleeding, intes nal obstruc on, diver culi s, persistent vitellointes nal duct fi stula, intussusep on, ulcera on or perfora on may occur 4 .…”