Simple diverticulectomy is adequate for management of bleeding Meckel diverticulum.

Creator(s)

Ian C. Glenn
Ibrahim Abd El-Shafy
Nicholas E. Bruns
E Pete Muenks, Children's Mercy HospitalFollow
Yara K. Duran, Children's Mercy HospitalFollow
Joshua A. Hill
Shawn D. St Peter, Children's Mercy HospitalFollow
Jose M. Prince
Aaron M. Lipskar
Todd A. Ponsky

Document Type

Article

Publication Date

4-1-2018

Identifier

DOI: 10.1007/s00383-018-4239-z

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.

Journal Title

Pediatric surgery international

Volume

34

Issue

4

First Page

451

Last Page

455

MeSH Keywords

Adolescent; Child; Child, Preschool; Digestive System Surgical Procedures; Disease Management; Female; Gastrointestinal Hemorrhage; Hospitalization; Humans; Infant; Infant, Newborn; Male; Meckel Diverticulum; Retrospective Studies

Keywords

Diverticulectomy; GI bleeding; Gastrointestinal hemorrhage; Meckel diverticulum; Small bowel resection

Recommended Citation

Glenn IC, El-Shafy IA, Bruns NE, et al. Simple diverticulectomy is adequate for management of bleeding Meckel diverticulum. Pediatr Surg Int. 2018;34(4):451-455. doi:10.1007/s00383-018-4239-z