Proceeding with incidentally discovered, unchanged Meckel’s diverticulum - a review

Abstract

Meckel’s diverticulum is the most common congenital malformation of the gastrointestinal tract, with the incidence approximately 1-4% in general population. In most persons Meckel’s diverticulum is an occult, asymptomatic anomaly, but in some may cause complications: bowel obstruction, bleeding and inflammation. The literature presents no precise recommendations on management of incidentally discovered, unchanged Meckel’s diverticulum. The goal of this study was to review literature on this topic aimed to determine current „state of art’ in this issue. Based on analysis of 17 papers, the following criteria (risk factors) were identified justifying „prophylactic” resection of fortuitously found, unchanged Meckel’s diverticulum: age <50 years, male gender, length >2 cm, macroscopic abnormalities suggesting the presence of mucosal heterotopy and narrow inlet (neck) of the diverticulum. In the cases meeting not these criteria, there is a minimal lifetime risk of complications development. Leaving diverticulum on site is recommended in cases of peritonitis, major abdominal trauma and in older age. Nevertheless, these indications to resect or not the diverticulum are relative, and surgeon is free and safe in decision making about this, depending on actual situation.