Symptomatic and Incidental Meckel’s Diverticulum in Children: Our Experience and Lesson

Abstract

Introduction: The management of incidentally detected Meckel’s Diverticulum (MD) at laparotomy or laparoscopy has been debatable. In asymptomatic cases, the surgical management is associated with complication of around 1% but the complication rates are variable in other conditions like peritonitis. Aim: To assess the management and outcome of incidentally diagnosed MD. Materials and Methods: A retrospective study was conducted from January 2012 to December 2019 using the case records of the patient. The study included all the patients who were diagnosed with cases of MD in the Department. The patients were divided into two groups: Symptomatic Group and Incidental Group. The case records of all the patients were reviewed and data were collected for the demographic details, mode of presentation, the basis of diagnosis, treatment, outcome and follow-up. Results: Total 132 patients were included in the study, 74 (56.06%) subjects were in symptomatic group and 58 (43.9%) were in incidental group. The mean age of symptomatic patients was 3.1±1.1 years and the incidental group was 6.5±2.4 years. It was significantly less in the symptomatic group (p≤0.001). All the patients in the symptomatic group were managed by laparotomy with diverticulectomy in 8 (10.8%), Wedge resection in 10 (13.5%) cases, segmental bowel resection in 44 (59.4%) and ileostomy in 12 (16.2%) cases. In the incidental group 9 (15.5%) patients underwent laparoscopic diverticulectomy and in rest 49 (66.2%) cases, only the primary procedure was performed. Six (10.3%) patients of incidental group without any intervention presented with complication in follow-up. Conclusion: The laparoscopic diverticulectomy of MD should be performed in incidentally diagnosed cases of younger age group.

Keywords

• diverticulectomy
• intestinal obstruction
• laparoscopy