Surgery is the best treatment option for Meckel’s diverticulum because the pouch will not grow back post-surgery.
Treatment for Meckel’s Diverticulum is determined by the severity of symptoms.
If Meckel's diverticulum is causing pain or bleeding, the doctor may advise the patient to have the diverticulum removed surgically.
The treatment of symptomatic Meckel's diverticulum is surgical resection, which might involve simple diverticulectomy or intestinal resection.
Laparoscopic resection has been recognized as a safe approach in both juvenile and adult populations.
Laparoscopic surgery for Meckel’s diverticulum
- The surgery is often performed under general anesthesia.
- The surgeon introduces a laparoscope through one of the tiny incisions in the abdomen, allowing them to observe the abdomen on a video display.
- They insert surgical tools through other incisions.
- The surgeon removes the Meckel's diverticulum and surrounding damaged parts of the small intestine.
- They staple or sew the remaining small intestine's healthy ends back together.
Benefits of laparoscopic treatment include:
- Mild postoperative pain
- A shorter hospital stay and quicker return to work and routine activities
- Excellent cosmetic results
Risks of laparoscopic treatment include:
- The risk of complications associated with surgical treatment of Meckel's diverticulum is less than two percent.
- Scar tissue causes postsurgical intestinal obstruction in about five to nine percent of individuals.
- Anesthesia can occasionally cause nausea.
Open surgery
- In extreme situations, the doctor recommends open surgery on the intestines.
- The surgeon removes the diverticulum-containing intestinal section, usually the ileum or upper intestines, during surgery.
- Following the removal of the diverticulum, the surgeon reconnects the healthy parts of the intestine.
Possible complications of surgery include:
- Hemorrhage (excess bleeding) from the diverticulum
- Folding of the intestines (intussusception), a type of blockage
- Peritonitis
- Tear (perforation) of the bowel at the diverticulum
Post treatment guidelines
- Rest and regulated feeding for about a month in infants are recommended.
- Rest and not lifting heavy weights along with regulated intake of food in the case of older children, adolescents, or adults are recommended.
- After going home, patients may need a few days of pain medication. They will have a follow-up appointment with the surgeon.
- Their stitches may need to be removed, and sometimes, absorbable stitches may be used.
- After two weeks, patients can start their regular activities.
Surgery is the best treatment option for Meckel’s diverticulum because the pouch will not grow back post-surgery.
What is Meckel’s diverticulum?
Meckel's diverticulum is a pouch on the bottom wall of the small intestine that exists at birth (congenital). The diverticulum may contain tissue from the stomach or pancreas. This pouch might sometimes bleed or get contaminated with fecal material. Alternatively, the intestine might coil around it. When this occurs, the Meckel’s diverticulum must be removed.
Meckel's diverticulum does not cause symptoms. However, infected or inflamed Meckel's diverticulum can result in the following:
- Blood in the stool
- Anemia (low levels of red blood cells) due to blood loss can cause low energy and pale skin
- Signs of infection such as fever, chills, or belly pain
- Signs of intestinal blockage such as nausea, vomiting, and pain
Causes of and risk factors for Meckel’s diverticulum
Meckel's diverticulum forms before birth and is formed by a segment of tissue that serves as a connection to the umbilical cord during early development. This tissue normally diminishes and is reabsorbed by the seventh week of pregnancy. However, in some cases, the tissue persists forming a pouch or bulge in the bottom section of the small intestine.
It is unknown why this tissue does not get reabsorbed; however, it might be due to a combination of hereditary and environmental factors that include:
- Men are more likely than women to develop Meckel's diverticulum.
- Complications are more likely to occur in male children younger than two years.
Diagnosis for Meckel’s diverticulum
A physical examination will be performed. Based on the patient’s symptoms, the doctor may suspect Meckel’s diverticulum, but it can be difficult to diagnose, especially in adults.
Meckel’s diverticulum without symptoms is generally discovered by chance after another surgery. It may be found with imaging tests, such as:
- Meckel’s scan (technetium-99m pertechnetate scan)
- Abdominal computed tomography scan
- Abdominal X-ray
- Abdominal ultrasound
Complications of Meckel’s diverticulum
Meckel's diverticulum does not usually create difficulties or necessitate treatment. Infection and inflammation of the pouch is one significant consequence known as Meckel's diverticulitis. Meckel's diverticulitis needs immediate medical care.
Meckel’s diverticulitis can cause severe symptoms that resemble appendicitis such as:
- Pain in the lower abdomen that worsens with sneezing, coughing, and deep breathing
- Loss of appetite
- Slight fever
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How serious is Meckel’s diverticulum?
Most occurrences of Meckel's diverticulum do not create any issues. In individuals who have not had symptoms, the risk of problems is almost negligible. Patients who are asymptomatic frequently do not require surgical intervention and can be conservatively managed. If it does create symptoms, they are typically not life-threatening if treated promptly.
- If the patient has an intestinal obstruction caused by the diverticulum, it might become dangerous if not addressed. The blockage shuts off the blood flow to the intestines. Surgery can correct this.
- Peritonitis is a dangerous and painful infection of the abdominal cavity.
- In rare circumstances, bleeding from the Meckel's diverticulum might become extensive. Significant blood loss can be fatal.
Without treatment in a symptomatic patient
- Meckel’s diverticulum can cause enough blood loss that can lead to shock.
- In some cases, the intestine could rupture and leak waste into the abdomen, increasing the risk of a serious infection.
- In rare cases, complications associated with Meckel’s diverticulum may be life-threatening.
Following treatment of Meckel's diverticulum, gastrointestinal function and nutrition are unaltered. Symptoms will not return following surgery to remove the pouch and any intestinal obstruction. The prognosis for someone with Meckel's diverticulum is excellent according to various studies.
Without treatment in an asymptomatic patient
- Treatment of Meckel's diverticulum symptoms is uncomplicated, with little or no medical dispute. When it comes to treatment choices, deciding whether to remove an asymptomatic Meckel's diverticulum might be contentious.
- According to certain studies, age may play a role in the choice to remove a Meckel's diverticulum. Adult research found that removing an asymptomatic diverticulum may help patients younger than 50 years.
- According to new studies, Meckel's diverticulum is related to an increased incidence of cancer; this risk increases with age, culminating around the eighth decade of life.
- This increased risk of malignancy, as well as the high rate of regional and distant metastatic disease observed in Meckel's diverticulum-associated carcinoma, will almost certainly become important factors in the ongoing debate about how to treat patients with asymptomatic, incidentally discovered Meckel's diverticulum.
