Abstract
BACKGROUND AND OBJECTIVES: Meckel diverticulum can present with a variety of complications but is often found incidentally during other surgical procedures. The role of laparoscopy in the management of Meckel diverticulum is established. We reviewed our experience with complicated cases of Meckel diverticulum in children managed with laparoscopy.
METHODS: A 15-year retrospective chart review revealed 14 cases of complicated Meckel diverticulum managed with laparoscopy. Incidentally found Meckel diverticulum and cases done by laparotomy were excluded. Ages varied from 2 years to 16 years old. There were 10 males and four females. Eight cases had small bowel obstruction; of those, three had extensive intestinal gangrene. Four cases had significant rectal bleeding, three had acute diverticulitis, and two had intussusception caused by the diverticulum.
RESULTS: Eleven cases were treated with laparoscopic Meckel diverticulectomy and three with laparoscopic-assisted bowel resection because of extensive gangrene of the intestine. Two of the three cases with significant intestinal gangrene returned several weeks later with small bowel obstruction secondary to adhesions. They were successfully managed with laparoscopic lysis of adhesions. There were no other complications.
CONCLUSIONS: Laparoscopy is safe and effective in the management of complicated Meckel diverticulum in children. Most cases can be managed with simple diverticulectomy. Laparoscopy is useful when the diagnosis is uncertain. When extensive gangrene is present, laparoscopy can help to mobilize the intestine and evaluate the degree of damage, irrigate and cleanse the peritoneal cavity, and minimize the incision necessary to accomplish the bowel resection.
| Original language | English (US) |
|---|---|
| Journal | JSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons |
| Volume | 18 |
| Issue number | 3 |
| DOIs | |
| State | Published - Jul 1 2014 |
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Keywords
- Bowel obstruction
- Bowel resection
- Laparoscopy
- Meckel's diverticulum
ASJC Scopus subject areas
- Surgery
Cite this
Laparoscopy and complicated meckel diverticulum in children. / Alemayehu, Hanna; Stringel, Gustavo; Lo, Irene J.; Golden, Jamie; Pandya, Samir; McBride, Whitney; Muensterer, Oliver.
In: JSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons, Vol. 18, No. 3, 01.07.2014.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Laparoscopy and complicated meckel diverticulum in children
AU - Alemayehu, Hanna
AU - Stringel, Gustavo
AU - Lo, Irene J.
AU - Golden, Jamie
AU - Pandya, Samir
AU - McBride, Whitney
AU - Muensterer, Oliver
PY - 2014/7/1
Y1 - 2014/7/1
N2 - BACKGROUND AND OBJECTIVES: Meckel diverticulum can present with a variety of complications but is often found incidentally during other surgical procedures. The role of laparoscopy in the management of Meckel diverticulum is established. We reviewed our experience with complicated cases of Meckel diverticulum in children managed with laparoscopy.METHODS: A 15-year retrospective chart review revealed 14 cases of complicated Meckel diverticulum managed with laparoscopy. Incidentally found Meckel diverticulum and cases done by laparotomy were excluded. Ages varied from 2 years to 16 years old. There were 10 males and four females. Eight cases had small bowel obstruction; of those, three had extensive intestinal gangrene. Four cases had significant rectal bleeding, three had acute diverticulitis, and two had intussusception caused by the diverticulum.RESULTS: Eleven cases were treated with laparoscopic Meckel diverticulectomy and three with laparoscopic-assisted bowel resection because of extensive gangrene of the intestine. Two of the three cases with significant intestinal gangrene returned several weeks later with small bowel obstruction secondary to adhesions. They were successfully managed with laparoscopic lysis of adhesions. There were no other complications.CONCLUSIONS: Laparoscopy is safe and effective in the management of complicated Meckel diverticulum in children. Most cases can be managed with simple diverticulectomy. Laparoscopy is useful when the diagnosis is uncertain. When extensive gangrene is present, laparoscopy can help to mobilize the intestine and evaluate the degree of damage, irrigate and cleanse the peritoneal cavity, and minimize the incision necessary to accomplish the bowel resection.
AB - BACKGROUND AND OBJECTIVES: Meckel diverticulum can present with a variety of complications but is often found incidentally during other surgical procedures. The role of laparoscopy in the management of Meckel diverticulum is established. We reviewed our experience with complicated cases of Meckel diverticulum in children managed with laparoscopy.METHODS: A 15-year retrospective chart review revealed 14 cases of complicated Meckel diverticulum managed with laparoscopy. Incidentally found Meckel diverticulum and cases done by laparotomy were excluded. Ages varied from 2 years to 16 years old. There were 10 males and four females. Eight cases had small bowel obstruction; of those, three had extensive intestinal gangrene. Four cases had significant rectal bleeding, three had acute diverticulitis, and two had intussusception caused by the diverticulum.RESULTS: Eleven cases were treated with laparoscopic Meckel diverticulectomy and three with laparoscopic-assisted bowel resection because of extensive gangrene of the intestine. Two of the three cases with significant intestinal gangrene returned several weeks later with small bowel obstruction secondary to adhesions. They were successfully managed with laparoscopic lysis of adhesions. There were no other complications.CONCLUSIONS: Laparoscopy is safe and effective in the management of complicated Meckel diverticulum in children. Most cases can be managed with simple diverticulectomy. Laparoscopy is useful when the diagnosis is uncertain. When extensive gangrene is present, laparoscopy can help to mobilize the intestine and evaluate the degree of damage, irrigate and cleanse the peritoneal cavity, and minimize the incision necessary to accomplish the bowel resection.
KW - Bowel obstruction
KW - Bowel resection
KW - Laparoscopy
KW - Meckel's diverticulum
UR - http://www.scopus.com/inward/record.url?scp=85006257562&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85006257562&partnerID=8YFLogxK
U2 - 10.4293/JSLS.2014.00015
DO - 10.4293/JSLS.2014.00015
M3 - Article
VL - 18
JO - Journal of the Society of Laparoendoscopic Surgeons
JF - Journal of the Society of Laparoendoscopic Surgeons
SN - 1086-8089
IS - 3
ER -