Meckel’s Diverticulum

Abstract

Meckel’s diverticulum is indicated for surgical treatment if complicated by ileus, diverticulitis, intussusception, ulcer/gastrointestinal bleeding, intestinal perforation, or diverticulum torsion. When Meckel’s diverticulum is resected due to gastrointestinal bleeding, ectopic gastric mucosa responsible for ulcers also needs to be resected completely. Recently, Meckel’s diverticulum has often been investigated laparoscopically. If the diverticulum is long, ectopic gastric mucosa is present at its tip, and its laparoscopic resection with an automated anastomosing device is also selected. However, in cases where the diverticulum has a broad base, ectopic gastric mucosa can be present anywhere within the diverticulum, thus requiring extra-abdominal wedge resection of the ileum (including the diverticulum) to avoid any ectopic gastric mucosa being left unresected. Ileectomy and end-to-end anastomosis are performed in cases where inflammatory Meckel’s diverticulum has formed a mass and in cases of severely disturbed circulation through the ileum due to intussusception, diverticulum torsion, or ileus.

The figures in this chapter are reprinted with permission from the Standard Pediatric Operative Surgery (in Japanese), Medical View Co., Ltd., 2013, with the exception of occasional newly added figures that may appear.