Top

Published in:

Open Access 01-12-2008 | Review

Emergency surgery for Meckel's diverticulum

Authors: Raj Kumar Sharma, Vir Kumar Jain

Published in: World Journal of Emergency Surgery | Issue 1/2008

Abstract

The current work attempts to highlight the various life threatening complications of Meckel's diverticulum and to present the surgical strategies used in the emergency conditions so far in the form of a review of the works presented in the literature. Our aim behind this presentation is to cover the possible indications, methods, their complications and the outcome of these surgical techniques. For this, we made an extensive literature search using Google and Pubmed with the words-"Meckel's diverticulum", "Complications", "Management" and "Emergency surgery". All the relevant articles containing the surgical aspects of symptomatic Meckel's diverticulum till May 2008 were collected and analyzed. Meckel's diverticulum is the remains of the prenatal yolkstalk (Vitellointestinal duct). Although it generally remains silent but life threatening complications may arise making it an important structure for having a detailed knowledge of its anatomical and pathophysiological properties to deal with such complications.

Available only for authorised users

Pollak Raymond: Adjunctive Procedure in Intestinal Surgery. Mastery of surgery Fifth edition. Edited by: Fischer JE. 2007, 1392-1393.

Evers BM: Small Intestine. In Sabiston Textbook of Surgery 17th edition.Edited by: Townsend CM. Elsevier; 2004:1366-1368.

Mortensen NJ, Jones O: The Small and Large Intestines. Bailey & Love's Short Practice of Surgery.24th edition. Edited by: Russell RCG, Williams NS, Bulstrode CJK Arnold. 2004:1159-1160.

Whang EE, Ashley SW, Zinner MJ: Small intestine. in Schwartz's Principles Of Surgery. eighth edition, Edited by: Brunicardi FC. 2005, McGraw-Hill, 1043-1044.

Yamaguchi M, Takeuchi S, Awazu S: Meckel's diverticulum: investigation of 600 patients in Japanese literature. Am J Surg. 1978, 136: 247-249. 10.1016/0002-9610(78)90238-6.CrossRef

Yahchouchy EK, Marano AF, Etienne JC, Fingerhut AL: Meckel's diverticulum. J Am Coll Surg. 2001, 192: 658-62. 10.1016/S1072-7515(01)00817-1.CrossRefPubMed

Levy AD, Hobbs CM: From the archives of the AFIP. Meckel diverticulum: radiologic features with pathologic correlation. Radiographics. 2004, 24: 565-87.PubMed

Arnold JF, Pellicane JV: Meckel's diverticulum: a ten-year experience. Am Surg. 1997, 63: 354-5.PubMed

Soltero MJ, Bill AH: The natural history of Meckel's diverticulum and its relation to incidental removal. Am J Surg. 1976, 32: 168-73. 10.1016/0002-9610(76)90043-X.CrossRef

10.

Rutherford RB, Akers DR: Meckel Diverticulum: A review of 148 pediatric patients with specific reference to the pattern of bleeding and to mesodiverticular vascular bands. Surgery. 1966, 59: 618-26.PubMed

11.

Palepu S: Axial volvulus of a giant meckel's diverticulum. Abdominal Surgery. 2007

12.

Park JJ, Wolff BG, Tollefson MK, Walsh EE, Larson DR: Meckel Diverticulum, The Mayo Clinic Experience With 1476 Patients (1950–2002). Ann Surg. 2005, 241 (3): 529-533. 10.1097/01.sla.0000154270.14308.5f.PubMedCentralCrossRefPubMed

13.

Stone PA, Hofeldt MJ, Campbell JE, Vedula G, DeLuca JA, Flaherty SK: Meckel diverticulum: ten-year experience in adults. South Med J. 2004, 97: 1038-41. 10.1097/01.SMJ.0000125222.90696.03.CrossRefPubMed

14.

Bărbulescu M, Burcoş T, Ungureanu CD, Zodieru-Popa I: Stromal tumor of Meckel's diverticulum – a rare source of gastrointestinal bleeding and a real diagnostic problem. Chirurgia (Bucur). 2005, 100 (1): 69-73.

15.

Cullen JJ, Kelly KA, Moir CR, Hodge DO, Zinsmeister AR, Melton LJ: Surgical management of Meckel's diverticulum. An epidemiologic, population-based study. Ann Surg. 1994, 220: 564-9.PubMedCentralCrossRefPubMed

16.

Ackerman Z, Peston D, Cohen P: Role of Helicobacter pylori Infection in Complications from Meckel's Diverticulum. Digestive Diseases and Sciences. 2003, 48 (6): 1068-1072. 10.1023/A:1023704410208.CrossRefPubMed

17.

Stewart IC: Neurovascular hamartoma in a Meckel's diverticulum. Br J Clin Pract. 1985, 39 (10): 411-2.PubMed

18.

Dumper J, Mackenzie S, Mitchell P, Sutherland F, Lynn M, Mew QD: Complications of Meckel's diverticula in adults. Can J Surg. 2006, 49 (5):

19.

Horn F, Trnka J, Simicková M, Duchaj B, Makaiová I: Symptomatic Meckel's diverticulum in children. Rozhl Chir. 2007, 86 (9): 480-2.PubMed

20.

Pozzato P, Brancaccio M, Sacco S, Virzì S, Ventrucci M: Capsule endoscopy for the detection of bleeding Meckel's diverticulum. Minerva Gastroenterol Dietol. 2006, 52 (3): 327-331.PubMed

21.

Kovács M, Davidovics S, Gyurus P, Rácz I: Identification of a Meckel's diverticulum bleeding by urgent capsule endoscopy. Orv Hetil. 2006, 147 (41): 2003-6.PubMed

22.

Frazzini VIJ, English WJ, Bashist B, Moore E: Case report. Small bowel obstruction due to phytobezoar formation within Meckel diverticulum: CT findings. J Comput Assist Tomogr. 1996, 20 (3): 390-2. 10.1097/00004728-199605000-00012.CrossRefPubMed

23.

Levy AD, Hobbs CM: Meckel Diverticulum: Radiologic Features with Pathologic Correlation, From the Archives of the AFIP. RadioGraphics. 2004, 24: 565-587. 10.1148/rg.242035187.CrossRefPubMed

24.

Schier F, Hoffmann K, Waldschmidt J: Laparoscopic removal of Meckel's diverticulum in children. Eur J Pediatr Surg. 1996, 6 (1): 38-39.CrossRefPubMed

25.

Ediz A, Salih P, Emre G, Feridun S: Laparoscopy-assisted Resection of Complicated Meckel's Diverticulum in Adults. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2002, 12 (3): 190-194. 10.1097/00129689-200206000-00012.CrossRef

26.

Mukai M, Takamatsu H, Noguchi H, Fukushige T, Tahara H, Kaji T: Does the external appearance of a Meckel's diverticulum assist in choice of the laparoscopic procedure?. Pediatr Surg Int. 2002, 18 (4): 231-3. 10.1007/s003830100663.CrossRefPubMed

27.

Ioannis DK, Tambaropoulos K, Martinos H, Pechlivanidis G, Davidis D, Noussis G: Meckel's diverticulum lithiasis: A case of small bowel obstruction due to a migrated Meckel's Enterolith. Indian journal of surgery. 2006, 68 (1): 41-43.

28.

Vasquez JC, Lee SH, Coimbra R, Hoyt DB: Small Bowel Obstruction Caused By A Meckel's Diverticulum Enterolith. The Internet Journal of Surgery. 2002, 3 (2):

29.

Tomikswa M, Taomoto J, Saku M, Takeshita M: A loop formation of meckels diverticulum; a case with obstruction of the ileum, Turkish journal of trauma and emergency surgery. Ulus Travma Acil Cerrahi Derg. 2003, 9 (2): 134-136.

30.

Sharma RK, Jain VK, Murari K, Kamboj S: Gangrenous Meckel's diverticulum causing acute intestinal obstruction in an adult. ANZ Journal of Surgery.

31.

Sy ED, Shan YS, Tsai HM, Lin CH: Meckel's diverticulum associated with ileal volvulus in a neonate. Pediatr Surg Int. 2002, 18 (5–6): 529-31.PubMed

32.

Neidlinger NA, Madan AK, Wright MJ: Meckel's diverticulum causing cecal volvulus. Am Surg. 2001, 67 (1): 41-3.PubMed

33.

Nakamoto Y, Saga T, Fujishiro S, Washida M, Churiki M, Matsuda K: Gallstone ileus with impaction at the neck of a Meckel's diverticulum. Br J Radiol. 1998, 71 (852): 1320-2.CrossRefPubMed

34.

Smart N, Immanuel A, Mercer-Jones M: Laparoscopic repai of a Littre's hernia with porcine dermal collagen implant (Permacol). Hernia. 2007, 11 (4): 373-6. 10.1007/s10029-007-0197-4.CrossRefPubMed

35.

Chirdan LB, Yusufu LM, Ameh EA, Shehu SM: Meckel's diverticulitis due to Taenia saginata: case report. East Afr Med J. 2001, 78 (2): 107-8.CrossRefPubMed

36.

Bennett GL, Birnbaum BA, Balthazar EJ: CT of Meckel's diverticulitis in 11 patients. AJR Am J Roentgenol. 2004, 182 (3): 625-9.CrossRefPubMed

37.

Toshiki S, Kunihiro H, Yutakata S, Shusaku K: A case of perforation of meckel's diverticulum by a fish bone, Journal of Japan. Surgical Association. 2004, 65 (9): 2405-2408.

38.

Daniell SJ: Foreign body perforation of a jejunal diverticulum. J R Soc Med. 1982, 75 (9): 747-9.PubMedCentralPubMed

39.

Bell CD, Mustard RA: Bay leaf perforation of Meckel's diverticulum. Can J Surg. 1997, 40 (2): 146-147.PubMedCentralPubMed

40.

Kazemia K, Jalaeianc H, Fattahib MR, Hosseinia SV, Shafieea M, Roshana N: Ruptured Meckel's Mesodiverticulum and Meckel's Diverticulum following Blunt Abdominal Trauma. Med Princ Pract. 2008, 17: 161-163. 10.1159/000112973.CrossRef

41.

De Mulder RM, Verschave JG: Perforated leiomyosarcoma of Meckel's diverticulum – Case report. Eur J surg. 1991, 157 (1): 69-70.PubMed

42.

Cates JM, Williams TL, Suriawinata AA: Intraductal papillary mucinous adenoma that arises from pancreatic heterotopia within a meckel diverticulum. Arch Pathol Lab Med. 2005, 129 (3): e67-9.PubMed

43.

Karadeniz Cakmak G, Emre AU, Tascilar O, Bektaş S, Uçan BH, Irkorucu O, Karakaya K, Ustundag Y, Comert M: Lipoma within inverted Meckel's diverticulum as a cause of recurrent partial intestinal obstruction and hemorrhage: a case report and review of literature. World J Gastroenterol. 13 (7): 1141-3. 2007 Feb 21

44.

Hemmings CT: Neuromuscular and vascular hamartoma arising in a Meckel's diverticulum. Pathology. 2006, 38 (2): 173-4. 10.1080/00313020600561989.CrossRefPubMed

45.

Hager M, Maier H, Eberwein M, Klingler P, Kolbitsch C, Tiefenthaler W, Mikuz G, Moser PL: Perforated Meckel's diverticulum presenting as a gastrointestinal stromal tumor: a case report. J Gastrointest Surg. 2005, 9 (6): 809-11. 10.1016/j.gassur.2004.12.005.CrossRefPubMed

46.

Carpenter SS, Grillis ME: Meckel's diverticulitis secondary to carcinoid tumor: an unusual presentation of the acute abdomen in an adult. Curr Surg. 2003, 60 (3): 301-3. 10.1016/S0149-7944(02)00745-6.CrossRefPubMed

47.

Qureshi SS, Ramadwar MR, Viswanathan S, Bakshi AV, Arora B, Gupta T, Laskar S, Medhi SS, Muckaden MA, Banavali SD, Pai SK, Desai SB, Kurkure PA: Desmoplastic small round cell tumor of Meckel's diverticulum. J Clin Oncol. 25 (22): 3372-4. 10.1200/JCO.2007.11.9487. 2007 Aug 1

48.

Jellouli M, Mekki M, Krichene I, Zakhama A, Belghith M, Jouini R, Sahnoun L, Rammeh S, Harbi A, Nouri A: Intra-abdominal desmoplastic small round cell tumor in childhood: case report and review of the literature. Bull Cancer. 2003, 90 (12): 1063-6.PubMed

49.

Khoury MG, Aulicino MR: Gastrointestinal stromal tumor (GIST) presenting in a Meckel's diverticulum. Abdom Imaging. 2007, 32 (1): 78-80. 10.1007/s00261-006-9019-x.CrossRefPubMed

50.

Leijonmarck CE, Bonman-Sandelin K, Frisell J, Raf L: Meckel diverticulum in the adult. Br J Surg. 1986, 73: 146-9. 10.1002/bjs.1800730225.CrossRefPubMed

51.

Sutter PM, Canepa MG, Kuhrmeier F, Marx A, Martinoli S: Carcinoid tumor in Meckel's diverticulum: case presentation and review of the literature. Schweiz Med Wochenschr Suppl. 1997, 89: 20S-24S.PubMed

52.

Saggar VR, Krishna A: Laparoscopy in suspected Meckel's diverticulum: negative nuclear scan notwithstanding. Indian Pediatr. 2004, 41 (7): 747-8.PubMed

53.

Shalaby RY, Soliman SM, Fawy M, Samaha A: Laparoscopic management of Meckel's diverticulum in children. J Pediatr Surg. 2005, 40 (3): 562-7. 10.1016/j.jpedsurg.2004.11.032.CrossRefPubMed

54.

McKay R: High incidence of symptomatic Meckel's diverticulum in patients less than fifty years of age: an indication for resection. Am Surg. 2007, 73 (3): 271-5.PubMed

55.

Palanivelu C, Rangarajan M, Senthilkumar R, Madankumar MV, Kavalakat AJ: Laparoscopic management of symptomatic Meckel's diverticula: a simple tangential stapler excision. JSLS. 2008, 12 (1): 66-70.PubMedCentralPubMed

56.

Ishigami S, Baba K, Kato K, Nakame K, Okumura H, Matsumoto M, Natsugoe S, Aikou T: Small bowel obstruction secondary to Meckel diverticulum detected and treated laparoscopically – case report. Surg Laparosc Endosc Percutan Tech. 2006, 16 (5): 344-6. 10.1097/01.sle.0000213740.62407.ae.CrossRefPubMed

57.

Târcoveanu E, Niculescu D, Georgescu S, Neacşu CN, Dimofte G, Moldovanu R, Epure O: Meckel's diverticulum in laparoscopic era. Chirurgia (Bucur). 2004, 99 (4): 227-32.

58.

Sanders LE: Laparoscopic treatment of Meckel's diverticulum. Obstruction and bleeding managed with minimal morbidity. Surg Endosc. 1995, 9: 724-7. 10.1007/BF00187950.CrossRefPubMed

59.

Sai Prasad TR, Chui CH, Singaporewalla FR, Ong CP, Low Y, Yap TL, Jacobsen AS: Meckel's diverticular complications in children: is laparoscopy the order of the day?. Pediatr Surg Int. 2007, 23 (2): 141-7. 10.1007/s00383-006-1844-z.CrossRefPubMed

60.

Cobellis G, Cruccetti A, Mastroianni L, Amici G, Martino A: One-trocar transumbilical laparoscopic-assisted management of Meckel's diverticulum in children. J Laparoendosc Adv Surg Tech A. 2007, 17 (2): 238-41. 10.1089/lap.2006.0036.CrossRefPubMed

61.

Varcoe RL, Wong SW, Taylor CF, Newstead GL: Diverticulectomy is inadequate treatment for short Meckel's diverticulum with heterotopic mucosa. ANZ J Surg. 2004, 74 (10): 869-72. 10.1111/j.1445-1433.2004.03191.x.CrossRefPubMed

62.

Rangarajan M, Palanivelu C, Senthilkumar R, Madankumar MV: Laparoscopic surgery for perforation of Meckel's diverticulum. Singapore Med J. 2007, 48 (4): e102-5.PubMed

63.

Steffen H, Ludwig K, Scharlau U, Czarnetzki HD: Laparoscopic treatment of small bowel obstruction with intussusception, volvulus and appendicitis caused by an inflammatory Meckel's diverticulum. Zentralbl Chir. 2003, 128 (2): 99-101. 10.1055/s-2003-37761.CrossRefPubMed

64.

El-Dhuwaib Y, O'Shea S, Ammori BJ: Laparoscopic reduction of an ileo-ileal intussusception and resection of an inverted Meckel's diverticulum in an adult. Surg Endosc. 2003, 17 (7): 1157-10.1007/s00464-002-4284-4.CrossRefPubMed

65.

Chan KW, Lee KH, Mou JW, Cheung ST, Tam YH: The use of laparoscopy in the management of Littre's hernia in children. Pediatr Surg Int. 2008 , 24 (7): 855-858. 10.1007/s00383-008-2161-5.CrossRefPubMed

66.

Prasad TR, Chui CH, Jacobsen AS: Laparoscopic-assisted resection of Meckel's diverticulum in children. JSLS. 2006, 10 (3): 310-6.PubMedCentralPubMed

67.

Ludtke FE, Mende V, Kohler H: Incidence and frequency of complications and management of Meckel's diverticulum. Surg Gynecol Obstet. 1989, 169: 537-542.PubMed

Title: Emergency surgery for Meckel's diverticulum
Authors: Raj Kumar Sharma
Vir Kumar Jain
Publication date: 01-12-2008
Publisher: BioMed Central
Published in: World Journal of Emergency Surgery / Issue 1/2008
Electronic ISSN: 1749-7922
DOI: https://doi.org/10.1186/1749-7922-3-27

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Emergency surgery for Meckel's diverticulum

Abstract

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2008

Intrathoracic drainage of a perforated prepyloric gastric ulcer with a type II paraoesophageal hernia

Metastatic Gas gangrene and Colonic Perforation: a case report

Severe bleeding from esophageal varices resistant to endoscopic treatment in a non cirrhotic patient with portal hypertension

Spectrum of perforation peritonitis in Pakistan: 300 cases Eastern experience

Synchronous multiple small bowel intussusceptions in an adult with blue rubber bleb naevus syndrome: Report of a case and review of literature

Perforated diverticulitis presenting as necrotising fasciitis of the leg