Laparoscopic management of Meckel’s diverticulum

Abstract

el’s diverticulum. Technetium has a high affinity for parietal cells of gastric mucosa. Because 95% of Meckel’s diverticulum contains ectopic gastric mucosa, this scan theoretically should identify most of Meckel’s diverticula. Accordingly, the sensitivity, specificity, and overall diagnostic accuracy of the scan is 80 %t o85% ,95% ,an d90% ,respectively. 2 Th efalse-negative rate is 1.7%, whereas the false-positive rate is only 0.05%, because of the abnormal accumulation of isotopes seen in intestinal duplications, Barrett’s esophagus, ulcers, inflammatory bowel disease, intussusception, arteriovenous malformations, an dneoplasm. 3 Patient swit hpersisten tgastrointestina lbleeding requiring multiple transfusions, whose source is unidentified by routine upper and lower endoscopy, angiography, and 99m Tc-pertechnetate scanning, must eventually undergo an abdominal exploration, often with endoscopic assistance; these patients usually have a midgut source, such as a Meckel’s diverticulum, small bowel stromal tumor, or arteriovenous malformation. Obviously, patients with a positive lesion on the 99m Tc-pertechnetate scan must undergo an abdominal exploration to remove the possible Meckel’s diverticulum. In both situations, the initial operative approach may be either laparoscopic or laparotomy, depending on a number of patient and physician factors.