Does an Incidental Meckel's Diverticulum Warrant Resection?

Shermeen Rahmat,Safeera Khan,Osama Sandhu,Zarmeena Aftab,Prerna Sangle

doi:10.7759/cureus.10307

Abstract

Meckel's diverticulum (MD) is the most common gastrointestinal malformation. The management of symptomatic Meckel's diverticulum has been undecidedly resection; however, the management of incidental Meckel's diverticulum has been fraught in comparison. As a systematic literature review, PubMed, PubMed Central (PMC), and MEDLINE were used. The search phrase utilized was "Meckel Diverticulum/Surgery [Mesh]" and resection incidental. The search was completed on July 18, 2020 and was limited to 1980 until the day of the search. Searches resulted in 62 initial articles on PubMed. On initial screening, 23 of these articles met the criteria. The references of these 23 articles were screened for relevant studies, yielding a total of 31 studies of which all were assessed for quality. Four articles made a recommendation for no resection. Twelve studies made a recommendation for resection. Ten studies concluded that resection should be completed in the presence of risk factors. Lastly, five studies made no clear recommendation. In recent literature, there has been a shift towards resection for all or in those with high-risk factors. In the future, it will be necessary for researchers to determine if resection is recommended for all patients with incidental MD or in those with risk factors. If only in those with risk factors, it will be important that research is completed to create evidence-based guidelines to support the risk factors.

Highlights

BackgroundMeckel's diverticulum (MD) is a congenital abnormality due to the failure of the vitelline duct to close
These two articles highlight the general level of confusion about many of the risk factors associated with MD
Resection is recommended if the MD has a length greater than two centimeters

Summary

Introduction

Meckel's diverticulum (MD) is a congenital abnormality due to the failure of the vitelline duct to close. It is the most common congenital gastrointestinal malformation, with studies demonstrating it is present in approximately two percent of the population [1]. It is a true diverticulum containing all three layers of the small bowel. The complications of Meckel's diverticulum have been well documented These include most commonly obstruction, followed by hemorrhage, perforation, diverticulitis, and intussusception [2].

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