Incidentally discovered Meckel's diverticulum: should I stay or should I go?

Tartaglia, Dario; Cremonini, Camilla; Strambi, Silvia; Ginesini, Michael; Biloslavo, Alan; Paiano, Lucia; Quilici, Francesca; Castagna, Maura; Saverio, Salomone Di; Coccolini, Federico; Chiarugi, Massimo

doi:10.1111/ans.16189

Cited by 6 publications

(6 citation statements)

References 21 publications

(29 reference statements)

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“…According to anatomical and histological analyses, in 50 % of cases the diverticulum is formed by ectopic tissue, with the gastric mucosa being the most common and associated with cases of hemorrhage, inflammation as well as perforation. There are also reports on pancreatic tissue [3] , [5] . The presence of these ectopic tissues strengthens the theory that justifies the etiopathogenesis related to MD aggravations.…”

Section: Discussionmentioning

confidence: 99%

“…It is the most common congenital anomaly of the digestive tract, more frequently seen in male children. It usually manifests with bleeding, obstruction, and inflammation (diverticulitis), and requires surgical treatment [3] . In adults, the disease is usually asymptomatic, often being accidentally diagnosed during imaging tests or surgery to treat other diseases, or due to further complications, with obstruction and diverticulitis being the most frequent symptoms in this age range [4] .…”

Section: Introductionmentioning

confidence: 99%

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Obstructive acute abdomen due to Meckel's diverticulum in adult: Case report

Villalaz

Rodriguez

Nunes

et al. 2022

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Obstructive acute abdomen due to Meckel's diverticulum in adult: Case report

Villalaz

Rodriguez

Nunes

et al. 2022

International Journal of Surgery Case Reports

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“…25 Tartaglia et al (2020) noting that incidental MD may harbor ectopic mucosa or tumor and given that stapled is low-risk, support diverticulectomy as a safe and effective for incidentally discovered MD. 37…”

Section: Against Imd Resectionmentioning

confidence: 99%

Should an Incidental Meckel Diverticulum Be Resected? A Systematic Review

Yagnik,

Garg,

Dawka

2024

CEG

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Background: Meckel Diverticulum [MD), a common congenital anomaly of the gastrointestinal tract, poses a dilemma when incidentally encountered during surgery. Despite historical descriptions and known complications of symptomatic MD, the decision to resect an incidental MD (IMD) lacks clear guidelines. This study aims to assess whether resecting IMDs is justified by synthesizing evidence from studies published between 2000 and 2023. Factors influencing this decision, such as demographic risks, surgical advancements and complications, are systematically examined. Methods and Material: Following the PRISMA 2020 guidelines, this review incorporates 42 eligible studies with data on outcomes of asymptomatic MD management. Studies, both favoring and opposing resection, were analyzed. Results: Considering complications, malignancy potential, and operative safety, the risk-benefit analysis presents a nuanced picture. Some authors propose conditional resection based on specific criteria, emphasizing patient-specific factors. Of 2934 cases analyzed for short-and long-term complications, the morbidity rate was 5.69%. Of 571 cases where mortality data were available, all 5 fatalities were attributed to the primary disease rather than IMD resection. Conclusion:The sporadic, unpredictable presentation of IMD and the variability of both the primary disease and the patient make formulation of definitive guidelines challenging. The non-uniformity of complications reporting underscores the need for standardized categorization. While the balance of evidence leans towards resection of IMDs, this study acknowledges the individualized nature of this decision. Increased safety in surgery and anesthesia, along with better understanding and management of complications favor a judicious preference for resection, while taking into account patient characteristics and the primary disease.

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“…El DM es el más común y representa el 90% de las anomalías del conducto vitelino (18). Hasta el 60% de los DM tienen mucosa heterotópica, mayormente mucosa gástrica (50%), pancreática (5%) y, con menos frecuencia, colónica, endometroide y hepatobiliar (7,20).…”

Section: Etiopatogeniaunclassified

“…El diagnóstico preoperatorio de la HL es poco probable, por la ausencia de manifestaciones clínicas y hallazgos radiológicos específicos, y generalmente se realiza intraoperatoriamente (12,20). La detección temprana de la progresión de una hernia encarcelada a una hernia estrangulada es difícil de lograr por medios clínicos o de laboratorio, lo que implica un gran desafío en el diagnóstico temprano (23).…”

Section: Diagnósticounclassified

Hernia de Littré

Condor Gualpa,

Yépez Yerovi

2024

Rev.méd.sinerg.

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La hernia de Littré es un hallazgo raro con menos de 100 casos reportados en la literatura, que se describe como la presencia de un divertículo de Meckel dentro de un saco herniario. Su incidencia es desconocida, pero se ha informado que el 1% de los pacientes con divertículo de Meckel desarrollará una hernia de Littré. Aunque el divertículo de Meckel es más común en hombres, la Hernia de Littré se presenta de manera similar tanto en hombres como en mujeres, y se expone típicamente como una hernia femoral, inguinal y umbilical. La hernia de Littré puede permanecer asintomática, siendo diagnosticada en forma incidental durante la cirugía, presentar síntomas y signos inespecíficos como dolor abdominal, distensión, náuseas y vómitos o desarrollar un cuadro complicado como estrangulamiento, encarcelamiento, perforación y fístula enterocutánea. Su diagnóstico definitivo, por lo general, se encuentra intraoperatoriamente durante la reparación de la hernia. El tratamiento es quirúrgico e incluye la reparación del defecto herniario y el manejo del divertículo de Meckel. La resección del divertículo de Meckel está indicada en los casos de hernia de Littré complicada, pero la resección en el contexto de un divertículo de Meckel asintomático hallado incidentalmente es un caso particular que plantea dilemas terapéuticos.

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Incidentally discovered Meckel's diverticulum: should I stay or should I go?

Cited by 6 publications

References 21 publications

Obstructive acute abdomen due to Meckel's diverticulum in adult: Case report

Obstructive acute abdomen due to Meckel's diverticulum in adult: Case report

Should an Incidental Meckel Diverticulum Be Resected? A Systematic Review

Hernia de Littré

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