From the Research
Surgical resection is the recommended treatment for symptomatic Meckel's diverticulum, with laparoscopic diverticulectomy or laparoscopic-assisted segmental resection being viable options. Meckel's diverticulum is a congenital outpouching of the small intestine, specifically the ileum, that occurs in approximately 2% of the population 1. It represents a remnant of the omphalomesenteric duct that failed to completely obliterate during fetal development. Meckel's diverticulum is often described by the "rule of 2s": it affects 2% of the population, is typically located within 2 feet of the ileocecal valve, is commonly 2 inches in length, and often becomes symptomatic before age 2. Most Meckel's diverticula contain normal intestinal mucosa, but about 50% contain heterotopic tissue, most commonly gastric mucosa (which can secrete acid and cause ulceration) or pancreatic tissue 2.
While many people with Meckel's diverticulum remain asymptomatic throughout life, complications can include gastrointestinal bleeding (often painless and presenting as maroon or bright red stools), intestinal obstruction, diverticulitis, or perforation. Diagnosis typically involves technetium-99m pertechnetate scan (Meckel's scan), which detects gastric mucosa in the diverticulum 3.
Some key points to consider in the management of Meckel's diverticulum include:
- The use of laparoscopic diverticulectomy or laparoscopic-assisted segmental resection as viable treatment options for symptomatic Meckel's diverticulum 4
- The importance of considering patient-specific factors in the management of incidental Meckel's diverticulum 2
- The need for a high index of suspicion and a multimodality combination of diagnostic tests, including Meckel's scan, small bowel capsule endoscopy, and device-assisted enteroscopy, to diagnose Meckel's diverticulum 1
Overall, the management of Meckel's diverticulum requires a thoughtful and individualized approach, taking into account the patient's symptoms, the presence of complications, and the results of diagnostic testing. Laparoscopic surgical resection is a safe and effective treatment option for symptomatic Meckel's diverticulum, with a low risk of complications and a high rate of success 5, 4.