Symptomatic Meckel's Diverticulum Research Articles

Meckel’s diverticulum mimicking acute appendicitis in children: a retrospective cohort study

BackgroundThe aims of this study were to summarize the clinical presentation and histological results of 20 cases of complicated Meckel diverticulum (MD) who were presumed to have acute appendicitis before surgery, as well as to improve the diagnosis and treatment of complicated MD in children.Materials and methodsWe retrospectively reviewed the records of 20 complicated MD admitted to our institution who were preoperatively diagnosed with acute appendicitis from January 2012 to January 2019. Patients were divided into the perforated MD group and the Meckel’s diverticulitis group. Patient demographics, clinical manifestations, laboratory data, auxiliary examinations, surgical methods, and the result of heterotopic tissue were recorded.ResultsA total of 20 cases of complicated MD (perforated or diverticulitis) were identified. Children were aged from 3 to 13 years, with a mean age of 7.75 years (median 7.75; range, 1–13 years). Perforated Meckel’s diverticulum occurred in 5 of 20 (25%) cases. For perforated MD versus diverticulitis, no significant differences were found between age, time to intervention, length of hospital stay, and distance from the ileo-cecal valve. Heterotopic tissue was confirmed on histopathology in 75% of all patients, including 10 cases of gastric mucosa, 3 cases of coexistent gastric mucosa and pancreatic tissue, and 2 cases of pancreatic tissue. All patients underwent diverticulectomy or partial ileal resection under laparoscopy or laparotomy; two cases combined with appendectomy owing to slight inflammation of the appendix.ConclusionsThe most common presentation of symptomatic MD is painless rectal bleeding; however, it can present symptoms of acute abdomen mimicking acute appendicitis. The key point of diverticulectomy is to remove the ectopic mucosa completely.

Symptomatic Meckel's Diverticulum in adult patients: our single center 6-year clinical experience and results

Amaç: Meckel divertikülü (MD), doğum sonrasında omfalomezenterik veya vitellin kanalın tam olmayan obliterasyonu sonucunda oluşan embriyolojik bir kalıntıdır ve gastrointestinal sistemin en sık gözlenen konjenital anomalisidir. MD genellikle asemptomatik olup; genellikle çocuk hasta popülasyonunda semptom vermektedir. Bu çalışmada; akut batının ayırıcı tanısında önemli yeri olan, preoperatif dönemde tanı konulmasının zor olduğu MD’nin güncel literatür bilgileri eşliğinde klinikopatolojik özelliklerinin analizi ve sonuçların incelenmesi amaçlandı.
 Gereç ve Yöntemler: Ocak 2017 - Ocak 2023 tarihleri arasında genel cerrahi kliniğinde Meckel divertikülü tanısı alan ve ameliyat edilen hastalar retrospektif olarak tarandı. Çalışmaya 18 yaşın altındaki hastalar ve inflamatuar bağırsak hastalığı tanısı olan hastalar dahil edilmedi. Hastaların preoperatif, intraoperatif ve postoperatif verileri incelenerek analiz edildi.
 Bulgular: Çalışmaya dahil edilen 22 olgunun yaş ortalaması 44,6 ± 14,6 yaş (20-74 yaş) idi. 16 olgu erkek, 6 olgu ise kadındı. Erkek/kadın oranı 2,7/1 idi. 7 olguda komorbid hastalık mevcuttu. Karın ağrısı (%72.7) en sık gözlenen semptom iken histopatolojik değerlendirmede 9 olguda heterotopik doku izlendi. Postoperatif cerrahi komplikasyon 6 hastada izlenirken en sık gözlenen komplikasyonun ileus (3 hasta) olduğu saptandı. Postoperatif süreçte bir hastada mortalite gözlendi.
 Sonuç: MD akut batında ayırıcı tanıda her zaman akılda bulundurulması gereken patolojilerdendir. Tanıda gecikilmesi ve ameliyat esnasında gözden kaçması özellikle semptomatik olan hastalarda ve başka akut batın sebepleri ile ilişkilendirilebilen patolojilerde mortalite ve morbidite oranlarını artırmaktadır.

The uncommon complications of Meckel's diverticulum: A single center case series study and literature review

Introduction and importanceMeckel's diverticulum is the most common congenital true diverticula of the gastrointestinal tract with 4–9% life time risk of complications. It is difficult to diagnose preoperatively other than having high index of suspicion. Therefore, the aim of this case series is to present the rare presentation of this disease and create awareness for clinician to deliver early intervention so that associated mortality and morbidity will be minimized. Case presentationHere we present four cases of Meckel's diverticulum managed in single center during a period of one year. Two cases were presented as isolated gangrenous Meckel's diverticulum with small bowel obstruction. The remaining two were: an adult male patient operated for generalized peritonitis as a result of perforated Meckel's diverticulitis and a child with intussusception in which Meckel's diverticulum was secondarily obstructed. Clinical discussionThe less frequent complications of Meckel's diverticulum are more challenging to diagnose. It carries higher rate of morbidities since early diagnosis is difficult; especially, isolated axial torsion of the Meckel's diverticulum that we are presenting in this case series. Therefore it is prudent to consider for a pain originating from central abdomen which gets diffuse in the meantime unlike symptoms of complicated appendicitis as symptomatic Meckel's diverticulum. ConclusionThe rare complications of Meckel's diverticulum need high index of suspicion to diagnose as their symptoms mimic other pathologies which cause diffuse abdominal pain. Timely intervention can prevent hospital mortality, morbidity and decrease duration of hospital stay.

Clinical characteristics and treatment outcomes of symptomatic Meckel diverticulum: a comparative study among children, adolescent, and adult patients.

We investigated the clinical characteristics and treatment outcomes of symptomatic Meckel diverticulum (MD) in adolescents by comparison with children and adults. We retrospectively reviewed the medical records of patients who underwent symptomatic MD surgery from January 2002 to December 2019. Demographic information, clinical presentations, preoperative evaluations, operative variables, postoperative outcomes, and pathologic findings were collected. We performed analyses by dividing all patients into three groups according to age at surgery: child group (<10 years), adolescent group (10-19 years), and adult group (≥20 years). Forty-three patients underwent symptomatic MD surgery (the child group, 14; the adolescent group, 17; and the adult group, 12). Vomiting and intestinal obstruction decreased significantly with age (P = 0.042 and 0.001), whereas hematochezia and gastrointestinal bleeding showed an increasing trend with age, although not statistically significant (P = 0.064 and 0.064). Ultrasound performance decreased significantly with age (P = 0.002), whereas CT performance showed an increasing trend with age, although not statistically significant (P = 0.193). Preoperative diagnosis rate increased significantly with age (P = 0.029). Laparoscopic surgery was performed significantly more in the adult group than in other groups (P = 0.001). The sizes of MD were significantly greater in the adolescent group than in other groups (P = 0.006 and 0.002). The clinical characteristics and treatment outcomes of symptomatic MD in adolescents exhibit a transitional pattern between children and adults. Therefore, it is important for clinicians to recognize that adolescent patients with symptomatic MD have the characteristics of both children and adult patients to ensure optimal care.

Meckel diverticulum in the pediatric population: Patient presentation and performance of imaging in prospective diagnosis

PurposeTo determine the most common presentations of Meckel diverticulum (MD) in children and the performance of imaging modalities in prospective diagnosis. Materials and methodsA 28-year retrospective review was performed of children under 18 years of age with MD listed as a diagnosis on pathology and/or surgical reports. The medical record was reviewed to determine presenting clinical scenarios. All imaging performed for each case was reviewed. ResultsSeventy-six patients met inclusion criteria. Of the surgically removed MD, most presented with abdominal symptoms (n = 31, 41%); gastrointestinal (GI) bleeding (n = 15, 20%), or both abdominal symptoms and GI bleeding (n = 7, 9%). Twenty-nine percent of MD were discovered incidentally at surgery performed for other reasons. Of the symptomatic MD, only 31% were prospectively diagnosed. For patients with abdominal symptoms, CT had a sensitivity of 13% (3/24) while nuclear medicine (NM) scan had a sensitivity of 0% (0/2). For patients with GI bleed, CT had a sensitivity of 29% (2/7) and NM scan had a sensitivity of 71% (10/14). For patients with both abdominal symptoms and GI bleed, CT was 0% (0/2) and NM scan 75% (3/4) sensitive. ConclusionMD as a cause of abdominal symptoms and gastrointestinal bleeding may be difficult to diagnose due to nonspecific presentations and nonspecific findings. Most prospectively diagnosed MD are on NM scan in patients with GI bleed with abdominal pain (sensitivity of >70%). CT is relatively insensitive for MD in all symptomatology groups (0 to 29%).

Gangrenous Meckel's diverticulum with small bowel obstruction mimicking complicated appendicitis: 'Case report'.

IntroductionThough Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, it is uncommon in the general population and rare in adults. Its preoperative diagnosis is challenging. While obstruction is the commonest complication, its occurrence with gangrenous Meckel's diverticulum is rare. The aim of this presentation is to report this combination and to create awareness among surgeons and radiologists to increase preoperative diagnosis of Meckel's diverticulum preventing morbidity and mortality from delay in intervention.Presentation of the caseA twenty-years-old male presented with periumblical pain that later shifted to lower abdomen, vomiting and fever of 10 h durations. He has no history of smoking or diabetes. Physical examination showed tachycardia, fever, and lower abdominal tenderness. Exploratory laparotomy revealed gangrenous Meckel's diverticulum and ileal obstruction by a band arising from the tip of diverticulum to ileal mesentery. We did segmental resection of the ileum containing Meckel's diverticulum and end-to-end anastomosis with the excellent outcome.DiscussionPreoperative diagnosis of Meckel's diverticulum is challenging because of non-specific clinical presentations and less sensitivity and specificity of imaging investigations. A high index of suspicion can improve its diagnosis. Axial torsion with gangrenous Meckel's diverticulum is the rarest complication. Management of symptomatic Meckel's diverticulum is surgery. Treatment of silent Meckel's diverticulum is controversial with no strong evidence to treat or not to treat.ConclusionGangrenous Meckel's diverticulum causing small bowel obstruction is rare. Surgeons must have a high index of suspicion to increase preoperative diagnosis of complicated Meckel's diverticulum.

Meckel's Diverticulum, A Rare Presentation in a Neonate.

Meckel's diverticulum is commonly symptomatic the first 2years of life. Complications associated with Meckel's diverticulum are due to gastrointestinal (GI) bleeding or obstruction. A 5-day-old male presented to the emergency department (ED) with an episode of bright red blood per rectum (BRBPR) associated with emesis. Vital signs were normal and abdomen soft and non-distended. Serial abdominal radiographs progressed to show distention of small bowel and air fluid levels. Operative intervention was undertaken with diagnosis of intestinal obstruction. On exploratory laparotomy, 24cm of a fibrosed, ischemic closed-loop ileal segment densely adherent to the tip of a Meckel's diverticulum was identified and resected, followed by primary reanastamosis. Histologic findings confirmed ectopic gastric tissue. Symptomatic Meckel's diverticulum is often secondary to intestinal obstruction and hematochezia, findings which are caused by incarcerated inguinal hernia or ileocolic intussusception. Our patient presented with a closed loop, which has not been previously reported.

Different clinical symptoms and surgical treatment of Meckel's diverticulum in children

Objective: Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract and is usually identified incidentally during surgery for other reasons, upon radiological workup while investigating another disease or during autopsy. Among certain major symptoms of Meckel's diverticulum include gastrointestinal bleeding, volvulus, diverticulitis, intussusception, Littre's hernia or stool discharge from the umbilicus. In this study, we examined pediatric patients who were operated on for Meckel's diverticulum presenting with different clinical symptoms.&#x0D; Methods: The files of pediatric patients who were operated for Meckel's diverticulum in the pediatric surgery clinic between July 2002 and July 2017 were retrospectively reviewed. Patients who underwent incidental diverticulectomy were excluded from the study.&#x0D; Results: The 47 patients included in the study were 34 boys, 13 girls, and their mean age was 4.8 (1 day, 16 years). 49% of the patients were younger than 2 years old. The most common symptom observed in the patients was abdominal pain (63.8%). The most common indication for surgery was intestinal obstruction (53.2%). Intussusception was the cause in 64% of the patients in whom intestinal obstruction was the initial diagnosis. We detected gastrointestinal (GI) bleeding complaint in 12.8% of the patients. Segmentary bowel resection (46.8%) was the most common surgical procedure. In the pathological examination, ectopic tissue was found in 27 (57.4%) pathological specimens. While postoperative complications developed in 9 patients, 4 patients were treated conservatively and 5 patients were treated surgically.&#x0D; Conclusion: Establishing a preoperative diagnosis of Meckel's diverticulum may be difficult non other than rectal bleeding with currant jelly stool. In symptomatic Meckel's diverticulum, simple diverticulectomy, wedge resection or segmental bowel resection should be planned according to the complication caused by the diverticulum.

Meckel's diverticulum associated with volvulus and internal hernia

Meckel's diverticulum (MD) is congenital malformation that usually asymptomatic. MD could be emergency cases in pediatric due to the complication. We report an interesting and rare case complication of MD in 5 years old children who presented with internal hernia and intestinal volvulus. The type ectopic epithelium that we have identified is an ectopic pancreatic tissue in the histopathology examination of MD resection tissue. Post-operative course, the patient got full recovery. Symptomatic MD can be present as the complication that can be severe emergency cases. Complication MD that we found is intestinal volvulus with the exceedingly rare associated case of internal hernia.

Epidemiology of Meckel's diverticulum: A nationwide population-based study in Taiwan: Characteristics of the cases from surgery between 1996 and 2013.

The diverse presentation of Meckel's diverticulum (MD) is a diagnostic challenge for clinicians and most previous studies consist of single institutional case series. The aim of this study was to review the related diagnoses of MD and to investigate the epidemiological characteristics using Taiwan's National Health Insurance Research Database.We conducted an observational study using a population-based database. Patients diagnosed with MD who concurrently received intestinal surgery were identified. We analyzed the patients’ demographic characteristics and relevant diagnoses using χ2 test and 2-sample t test.We identified 2453 newly diagnosed MD patients from 1996 to 2013 and 1227 patients (50%) with intestinal obstruction, gastrointestinal bleeding, and acute appendicitis (acute abdominal pain) were defined as symptomatic. The male to female ratio was 2.4:1 with half of the patients experiencing symptomatic MD before the age of 20 years’ old. The age-specific and annual incidence were calculated for all MD and symptomatic MD. Among the symptomatic MD patients, intestinal obstruction was present in 583 (48%), acute appendicitis was present in 464 (38%), and gastrointestinal bleeding was present in 283 (23%) patients. Intestinal obstruction was the most common preoperative diagnosis in the 0 to 10 years and >20 years’ age groups, and acute appendicitis (acute abdominal pain) was the most common diagnosis in the 11 to 20 years’ age group.This population-based 18 years’ epidemiologic study described the distributions of MD symptoms among different age groups, which may help clinicians gain a better understanding of this diagnostically challenging gastrointestinal anomaly.

Management of Symptomatic Meckel's Diverticulum in Infants and Children

Abstract Objectives The primary objective of the present study was to review the demographics of infants and children operated upon for Meckel's diverticulum. The secondary objectives were to review the clinical characteristics, surgical procedures performed, postoperative complications, and the outcome. Materials and Methods This study is a single-institutional, retrospective study and descriptive in nature. It consisted of infants and children below 12 years who were operated upon for Meckel's diverticulum at the author's institute and included data from January 1, 2000 to December 31, 2020. Results Eighty-four children below 12 years were operated upon for Meckel's diverticulum during the study period. The ratio for males to females was 3:1. This study consisted of infants, (n = 22, 26.19%), children of 1 to 5 years of age (n =19, 22.61%), and children of 6 to 12 years of age (n = 43, 51.19%). Clinically, children with Meckel's diverticulum presented in the following order of frequency: (1) intestinal obstruction (n = 59, 70.23%), (2) perforation peritonitis (n = 17, 20.23%), (3) lower gastrointestinal bleeding (n = 4, 4.76%), and (4) incidental finding (n = 4, 4.76%). In 35 (41.66%) children, bowel gangrene was detected. One-fifth (n = 17) of Meckel's diverticulum was responsible for the secondary intussusception. The surgical procedures were performed in the following order of frequency: (1) resection of Meckel's diverticulum, an adjacent segment of ileum and ileoileal anastomosis (n = 36, 42.85%); (2) Meckel's diverticulectomy (n = 32, 38.09%); (3) resection of Meckel's diverticulum, an adjacent segment of ileum with or without cecum and an ileostomy (n = 12, 14.28%); and (4) resection of Meckel's diverticulum, an adjacent segment of ileum, cecum, part of the colon, and ileocolic anastomosis (n = 4, 4.76%). In 8 (9.52%) children, complications were documented during the postoperative period. The present study observed three (3.57%) deaths during the postoperative period. Conclusion Meckel's diverticulum was one of the common causes of acute intestinal obstruction in infants and older children. Ninety percent of children with Meckel's diverticulum presented with features of an acute abdomen. Forty percent of children evidenced bowel gangrene during the surgical procedures. In these children, early diagnosis, timely referral, and institution of surgical therapy for acute abdomen/intestinal obstruction may prevent the development of bowel gangrene and the requirement of bowel resections to some extent.

Ruptured Meckel's diverticulum coexisting with a duplex appendix

Duplicate appendix is a rare anatomic variation of the vermiform appendix with an incidence rate of 0.004–0.009 %. A Meckel's diverticulum (MD) is a common congenital anomaly resulting from the persistence of the omphalomesenteric duct. It may present as lower gastrointestinal hemorrhage, intestinal obstruction, or inflammation. The co-existence of a MD and duplex appendix is rare and our literture search revealed only 2 previous reports. The objective of this article is to report a co-existing duplex appendix and symptomatic MD in a child, review the literature, and illustrate the challenges with the diagnostic process in a resource-limited setting. We present a 3-year-old male who was referred to our facility following a successful reduction of an incarcerated umbilical hernia at a peripheral facility. He presented 5 days later with signs of peritonitis and was optimized for surgery. Laparotomy was performed which revealed perforated MD with minimal peritoneal soiling. He also had an incidental duplex appendix consistent with Cave-Wallbridge type B1 and a 2 × 2cm umbilical defect. Segmental resection of the MD, double appendectomies, and peritoneal lavage was performed. A co-existing duplex appendix with MD is extremely rare. Complications of MD are challenging to diagnose. A duplex appendix has clinical and medicolegal implications. Surgeons should explore the cecum during appendectomy to avoid missed diagnosis.

Gastrointestinal Bleeds.

Gastrointestinal Bleeds.

The magnetic resonance enterography imaging features of symptomatic Meckel's diverticulum in pediatric patients: a retrospective observational study of 31 cases.

BackgroundThe aim of this study was to explore the magnetic resonance enterography (MRE) imaging manifestations of a symptomatic Meckel’s diverticulum (MD) in pediatric patients in order to provide a reference for the diagnosis of the condition.MethodsThe medical records of 31 pediatric patients with MD from May 2014 to October 2020 were retrospectively analyzed. The inclusion criteria were patients with MD accompanied by unexplained gastrointestinal bleeding, anemia (except hematological diseases), chronic persistent abdominal pain, repeated intussusception, or intussusception in older pediatric patients during surgery. The clinical variables (age, sex, and hemoglobin) and imaging, surgical, and pathological findings were recorded.ResultsMD was definitively identified in 28 patients, with the following characteristics: a blind-ending fluid-filled and/or gas-filled structure (n=23), an elongated shape (n=1), a dumbbell shape (n=1), and a solid mass (n=3). The diverticula were located in the right lower quadrant (n=16), the right abdomen at the level of the umbilicus (n=3), the right upper quadrant (n=2), the left upper quadrant (n=2), and the midline lower abdomen (n=5). Supply arteries were visualized in nine cases. In all cases, mural enhancement was comparable to that of the adjacent small-bowel (SB). Extravasation of the intravascular contrast medium was seen in two cases. Peripheral structural abnormalities included mesenteric fat stranding (n=7), hemorrhage in the adjacent lumen (n=3), free intraperitoneal gas (n=1), abnormal fluid retention (n=2), intestinal obstruction (n=1), and lymph node enlargement (n=7). A normal appendix was identified in 18 cases.ConclusionsMRE is an appropriate method of diagnosing symptomatic MD in pediatric patients and is particularly useful in the assessment of complications.

A case report of a ruptured Meckel's diverticulum with ectopic gastric and pancreatic tissue with negative computed tomography.

IntroductionA Meckel's diverticulum is a rare but known cause of an acute abdomen and can often be confused for acute appendicitis on physical examination. It is caused by an incomplete closure of the omphalomesenteric duct. It is present in 2% of the population and only 2% of those patients are symptomatic.Case presentationThis is the case of a sixty-four-year-old male presented to the surgical clinic at request of his primary care physician with concern for acute appendicitis. The patient had a CT A/P with IV contrast performed two days prior to his office visit for the same pain which was non-diagnostic. The patient was taken to the operating room and found to have Meckel's Diverticulitis which was managed by laparoscopic hand-assisted small bowel resection and anastomosis. The patient had an uncomplicated postoperative course. Pathology demonstrated ulcerated gastric mucosa and pancreatic tissue.DiscussionSymptomatic Meckel's diverticulum is managed with small bowel resection versus diverticulectomy based on characteristics of the diverticulum. The most common type of ectopic tissue is gastric followed by pancreatic. It is rare to find both types of tissue together.ConclusionThis case describes an unusual case of a rare acute surgical pathology with non-diagnostic imaging and labs. This case also describes an exceedingly rare histopathology of a Meckel's Diverticulum with the presence of both ectopic gastric and pancreatic tissues.

Intussusception with ischemia secondary to Meckel's Diverticulum in a 13 year old

This case demonstrates a rare presentation of a 13 year old boy who attended a rural Emergency Department with severe epigastric pain, nausea and vomiting. On arrival he was hypertensive and clinical examination found him to have tenderness most pronounced in the right iliac fossa leading to presumed diagnosis of appendicitis. However, upon surgical review it was felt his clinical examination and symptoms were inconsistent with those typically found in acute appendicitis. Ultrasound and abdominal x-ray were performed which did not clearly identify a cause for the patient's presentation however formal reports were not readily obtainable as this occurred after hours at our rural facility. Due to his clinical appearance and a significantly raised white cell count the decision was made to perform a diagnostic laparoscopy as it was evident he had a serious intra-abdominal pathology. Intra-operatively we determined the patient to have ischaemic bowel secondary to intussusception. Following resection of the affected bowel we identified an inverted Meckel's diverticulum to have been the lead point. This case is of clinical significance due to its unclear initial presentation as well as the patient being beyond the normal age range for both intussusception and symptomatic Meckel's Diverticulum.

Clinicopathologic Characteristics and Treatment Outcomes of Symptomatic Meckel's Diverticulum in Children

Clinicopathologic Characteristics and Treatment Outcomes of Symptomatic Meckel's Diverticulum in Children

Does an Incidental Meckel's Diverticulum Warrant Resection?

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.

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

Recent reports have recommended laparoscopic diverticulectomy for symptomatic Meckel diverticulum (MD) rather than laparoscopic-assisted extracorporeal resection. This technique may risk leaving residual ectopic mucosa leading to complications. This systematic review attempts to quantify the relative risks of both approaches. A systematic review was conducted according to PRISMA guidelines. Articles were eligible for inclusion if they reported data on the laparoscopic management of symptomatic MD in children. Eleven reports were identified, all of which were institutional retrospective studies. Pooled outcome data on 248 children showed no statistically significant difference in complications between laparoscopic diverticulectomy (n = 133) and laparoscopic-assisted segmental resection (n = 115) (3% vs. 6.1%, p = 0.39). One patient from the diverticulectomy group re-presented with recurrent bleeding necessitating segmental small bowel resection. Conclusions are limited by the number of patients and variable follow up. Short, wide MD with a height:base ratio of < 2; diverticula with thickening or ischemia at the base and those complicated by volvulus or small bowel obstruction are probably best treated by laparoscopic-assisted extracorporeal resection. For other symptomatic diverticula laparoscopic diverticulectomy is a reasonable approachwith a less than 1% risk of leaving residual ectopic gastric mucosa.

Clinicodemographic Profile and Outcome of Patients with Symptomatic Meckel's Diverticulum: Preliminary Findings

Background: Meckel's diverticulum is the commonest gastrointestinal congenital anomaly. Though most of the cases do not present clinically, they are challenging to diagnose if become symptomatic. Spectrum of clinical presentation may be different from umbilical fistula, omphalomesenteric cyst to fibrous band from diverticulum to umbilicus. Bleeding, obstruction and infection are the most common complications. Vast majority of them are detected only intra-operatively. &#x0D; Methods: We analyzed our patients who were intra-operatively diagnosed as symptomatic Meckel's Diverticulum. Socio-demographic profile and immediate outcome of operated patients was analyzed from patient's records.&#x0D; Results: Total 9 patients were operated for symptomatic Diverticulitis. All patients were diagnosed intraoperatively. Intestinal obstruction was the commonest presentation. Diverticulectomy was the most common procedure performed followed by wedge resection and segmental bowel resection.&#x0D; Conclusions: Symptomatic Meckel’s Diverticulum is difficult to diagnose pre-operatively. Vast majority of them are found only intra-operatively. Most of the patients do well after resection of Meckel's Diverticulum.&#x0D; Keywords: Meckel’s diverticulum; surgery; symptoms.