PakMediNet Discussion Forum : Surgery : Meckels diverticulum-to resect or leave
What policy procedures are being followed by my colleagues ,if during operation of appendectomy a Meckels diverticulm is found in presence of acutely infllammed appendix; The meckels diverticulm is not inflammed- you will leave it or resect it ; what guidelines you are following;Dr Fiaz Maqbool Fazili Acute Care surgeon King Fahd hospital medinah munawarah Saudi Arabia
Posted by: fiazfazili Posts: 16 :: 16-04-2007 :: | Reply to this Message
There has been more controversy in the past about the management of an incidentally found asymptomatic diverticula. However, it is now generally agreed that it should be removed in patients under the age of 50.
(McKay R; High incidence of symptomatic Meckel's diverticulum in patients less than fifty years of age: an indication for resection. Am Surg. 2007 Mar;73(3):271-5)
http://www.ncbi.nlm.nih.gov/pubmed/17375785?dopt=Abstract
[Edited by shami1978 on 24-06-2009 at 07:48 PM GMT]
Posted by: shami1978 Posts: 12 :: 24-06-2009 :: | Reply to this Message
AT the moment I can't give you any reference but just my personal experience and strategy.In my humble opinion,
we don't fiddle with it if found incidentally and looking harmless(wide mouthed and no thickening of wall).
I don't think it would be wise to excise it and therefore creating an anastomosis or repair in otherwise normal gut with all the possible attendant risks of it( repair) failing afterwards. For patient, a smoother post appendectomy course is more likely to become a nightmarish one.
Besides a "meckle" is rarely to get infected in lifetime and usually an autopsy finding. I dont think that chances of it causing problem in life later on are statistically significant. But i confess and regret that i don't have solid data to support my claim. Its more of my experience and what i have seen my seniors doing in general.
[Edited by drfarhan on 25-06-2009 at 06:33 PM GMT]
Posted by: drfarhan Posts: 93 :: 25-06-2009 :: | Reply to this Message