Incidentally detected Meckel diverticulum: to resect or not to resect?

Abstract

BACKGROUND Management of incidentally detected Meckel diverticulum (MD) remains controversial. Our aims were to establish: (1) the prevalence of MD; (2) the morbidity and (3) mortality due to MD. METHODS Systematic review: A total of 244 papers meeting defined criteria were included; there were no prospective or randomized studies. MD prevalence and mortality from autopsy studies, postoperative complications, and outcome of incidentally detected MD were extracted. Population-based data: Data were obtained from national databases on MD as cause of death, and on number of MD resections per year. RESULTS The prevalence of MD is 1.2% and historical mortality of MD was 0.01%. The current mortality from MD is 0.001%. The number of MD resections per year per 100,000 population decreased significantly after the pediatric age range (P < 0.001). Resection of incidentally detected MD has a significantly higher postoperative complication rate than leaving it in situ (P < 0.0001). The long-term outcome of patients with incidentally detected MD left in situ showed no complications. Seven-hundred fifty-eight patients would require incidentally detected MD resection to prevent 1 death from MD. CONCLUSIONS MD is present in 1.2% of the population, it is a very rare cause of mortality, and it is primarily a disease of the young. Leaving an incidentally detected MD in situ reduces the risk of postoperative complications without increasing late complications. A large number of MD resections would need to be performed to prevent 1 death from MD. The above evidence does not support the resection of incidentally detected MD.

DOI: 10.1097/SLA.0b013e31815aaaf8
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@article{Zani2008IncidentallyDM, title={Incidentally detected Meckel diverticulum: to resect or not to resect?}, author={Augusto Zani and Simon Eaton and Clare M. Rees and Agostino Pierro}, journal={Annals of surgery}, year={2008}, volume={247 2}, pages={276-81} }