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Meckel's Diverticulum in Adults: Surgical Concerns

Since Meckel's diverticulum (MD) is rarely diagnosed in adults, there is no consensus on what type of procedure to be performed for symptomatic MD and whether to resect or not an accidentally discovered MD. Treatment of symptomatic MD is definitive surgery, including diverticulectomy, wedge, an...

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Autores principales: Blouhos, Konstantinos, Boulas, Konstantinos A., Tsalis, Konstantinos, Barettas, Nikolaos, Paraskeva, Aikaterini, Kariotis, Ioannis, Keskinis, Christodoulos, Hatzigeorgiadis, Anestis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6129587/
https://www.ncbi.nlm.nih.gov/pubmed/30234126
http://dx.doi.org/10.3389/fsurg.2018.00055
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author Blouhos, Konstantinos
Boulas, Konstantinos A.
Tsalis, Konstantinos
Barettas, Nikolaos
Paraskeva, Aikaterini
Kariotis, Ioannis
Keskinis, Christodoulos
Hatzigeorgiadis, Anestis
author_facet Blouhos, Konstantinos
Boulas, Konstantinos A.
Tsalis, Konstantinos
Barettas, Nikolaos
Paraskeva, Aikaterini
Kariotis, Ioannis
Keskinis, Christodoulos
Hatzigeorgiadis, Anestis
author_sort Blouhos, Konstantinos
collection PubMed
description Since Meckel's diverticulum (MD) is rarely diagnosed in adults, there is no consensus on what type of procedure to be performed for symptomatic MD and whether to resect or not an accidentally discovered MD. Treatment of symptomatic MD is definitive surgery, including diverticulectomy, wedge, and segmental resection. The type of procedure depends on: (a) the integrity of diverticulum base and adjacent ileum; (b) the presence and location of ectopic tissue within MD. The presence of ectopic tissue cannot be accurately predicted intraoperatively by palpation and macroscopic appearance. When present, its location can be predicted based on height-to-diameter ratio. Long diverticula (height-to-diameter ratio >2) have ectopic tissue located at the body and tip, whereas short diverticula have wide distribution of ectopic tissue including the base. When indication of surgery is simple diverticulitis, diverticulectomy should be performed for long and wedge resection for short MD. When indication of surgery is complicated diverticulitis with perforated base, complicated intestinal obstruction and tumor, wedge, or segmental resection should be performed. When the indication of surgery is bleeding, wedge and segmental resection are the preferred methods for resection. Regarding management of incidentally discovered MD, routine resection is not indicated. The decision making should be based on risk factors for developing future complications, such as: (1) patient age younger than 50 years; (2) male sex; (3) diverticulum length >2 cm; and (4) ectopic or abnormal features within a diverticulum. In this case, diverticulectomy should be performed for long and wedge resection for short MD.
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spelling pubmed-61295872018-09-19 Meckel's Diverticulum in Adults: Surgical Concerns Blouhos, Konstantinos Boulas, Konstantinos A. Tsalis, Konstantinos Barettas, Nikolaos Paraskeva, Aikaterini Kariotis, Ioannis Keskinis, Christodoulos Hatzigeorgiadis, Anestis Front Surg Surgery Since Meckel's diverticulum (MD) is rarely diagnosed in adults, there is no consensus on what type of procedure to be performed for symptomatic MD and whether to resect or not an accidentally discovered MD. Treatment of symptomatic MD is definitive surgery, including diverticulectomy, wedge, and segmental resection. The type of procedure depends on: (a) the integrity of diverticulum base and adjacent ileum; (b) the presence and location of ectopic tissue within MD. The presence of ectopic tissue cannot be accurately predicted intraoperatively by palpation and macroscopic appearance. When present, its location can be predicted based on height-to-diameter ratio. Long diverticula (height-to-diameter ratio >2) have ectopic tissue located at the body and tip, whereas short diverticula have wide distribution of ectopic tissue including the base. When indication of surgery is simple diverticulitis, diverticulectomy should be performed for long and wedge resection for short MD. When indication of surgery is complicated diverticulitis with perforated base, complicated intestinal obstruction and tumor, wedge, or segmental resection should be performed. When the indication of surgery is bleeding, wedge and segmental resection are the preferred methods for resection. Regarding management of incidentally discovered MD, routine resection is not indicated. The decision making should be based on risk factors for developing future complications, such as: (1) patient age younger than 50 years; (2) male sex; (3) diverticulum length >2 cm; and (4) ectopic or abnormal features within a diverticulum. In this case, diverticulectomy should be performed for long and wedge resection for short MD. Frontiers Media S.A. 2018-09-03 /pmc/articles/PMC6129587/ /pubmed/30234126 http://dx.doi.org/10.3389/fsurg.2018.00055 Text en Copyright © 2018 Blouhos, Boulas, Tsalis, Barettas, Paraskeva, Kariotis, Keskinis and Hatzigeorgiadis. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Blouhos, Konstantinos
Boulas, Konstantinos A.
Tsalis, Konstantinos
Barettas, Nikolaos
Paraskeva, Aikaterini
Kariotis, Ioannis
Keskinis, Christodoulos
Hatzigeorgiadis, Anestis
Meckel's Diverticulum in Adults: Surgical Concerns
title Meckel's Diverticulum in Adults: Surgical Concerns
title_full Meckel's Diverticulum in Adults: Surgical Concerns
title_fullStr Meckel's Diverticulum in Adults: Surgical Concerns
title_full_unstemmed Meckel's Diverticulum in Adults: Surgical Concerns
title_short Meckel's Diverticulum in Adults: Surgical Concerns
title_sort meckel's diverticulum in adults: surgical concerns
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6129587/
https://www.ncbi.nlm.nih.gov/pubmed/30234126
http://dx.doi.org/10.3389/fsurg.2018.00055
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