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01-04-2018 | Original Article

Simple diverticulectomy is adequate for management of bleeding Meckel diverticulum

Authors: Ian C. Glenn, Ibrahim Abd el-shafy, Nicholas E. Bruns, E. Pete Muenks, Yara K. Duran, Joshua A. Hill, Shawn D. St. Peter, Jose M. Prince, Aaron M. Lipskar, Todd A. Ponsky

Published in: Pediatric Surgery International | Issue 4/2018

Abstract

Purpose

It is unclear whether simple diverticulectomy, rather than segmental bowel resection (SBR), is adequate treatment for gastrointestinal bleeding (GIB) secondary to Meckel diverticulum (MD). There is concern that ulcers in the adjacent bowel may continue to bleed if only the diverticulum is removed. This study seeks to determine if diverticulectomy is satisfactory treatment for bleeding MD.

Methods

A multi-institution, retrospective review was performed for patients with a diagnosis of MD and GIB who underwent simple diverticulectomy or small bowel resection. Exclusion criteria were comorbid surgical conditions and other causes of GIB. The primary outcome was post-operative bleeding during the initial hospitalization. Secondary outcomes were bleeding after discharge, transfusion or additional procedure requirement, re-admission, and overall complications.

Results

There were 59 patients who met study criteria (42 diverticulectomy, 17 SBR). One patient in the SBR group had early post-operative bleeding (p = 0.288). There was one re-admission (p = 0.288) and three total complications in the SBR group (p = 0.021). There were no cases of bleeding or other complications in the diverticulectomy group.

Conclusion

This study suggests that simple diverticulectomy is adequate for treatment of GIB caused by MD. Furthermore, diverticulectomy appears to have a lower overall complication rate.

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Title: Simple diverticulectomy is adequate for management of bleeding Meckel diverticulum
Authors: Ian C. Glenn
Ibrahim Abd el-shafy
Nicholas E. Bruns
E. Pete Muenks
Yara K. Duran
Joshua A. Hill
Shawn D. St. Peter
Jose M. Prince
Aaron M. Lipskar
Todd A. Ponsky
Publication date: 01-04-2018
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Surgery International / Issue 4/2018
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-018-4239-z

At a glance: The STEP trials

Springer Medicine

Simple diverticulectomy is adequate for management of bleeding Meckel diverticulum

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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