Skip to main content

The Significance of Meckel’s Diverticulum in Appendicitis — A Retrospective Analysis of 233 Cases

World Journal of Surgery volume 29, pages 455–458 (2005)Cite this article

Abstract

Conflicting reports are found in the literature concerning whether to remove an incidentally discovered Meckel’s diverticulum (MD). Between 1.1.1974 and 31.12.2000, at a single center, the perioperative data associated with appendectomy (AE) were recorded consecutively and analyzed retrospectively. All patients in whom an MD was discovered during an AE were included in the study. The clinical presentation, postoperative course, and follow-up in all MDs left in place were analyzed. During the course of 7927 AE, 233 MD (2.9%) were detected. Of these 80.7% (n = 188) were removed and 19.3% (n = 45) were left untouched. In 9% (n = 21) of all detected diverticula pathological changes were found. Ectopic tissue was seen in 12.2% (n = 23) of the MDs removed. The postoperative complication rates did not differ significantly between patients in whom the MD was removed (9.5%; n = l8) and those in whom it was not (17.7%; n = 8); in the latter group the appendicitis was of the more acute type (gangrenous or perforated) (24.4% vs. 4.3%). In 18 patients (40.0%) with non-removed MDs, a follow-up period of 14.1 ± 5.8 years was achieved. Complications associated with a non-removed MD were not observed. If during the course of an AE a MD is detected, the present data, as well as those in the literature, suggest that an individualized approach should be taken. Meckel’s diverticulum with obvious pathology should always be removed. In cases of gangrenous or perforated appendicitis, an incidentally discovered MD should be left in place, whereas in an only mildly inflamed appendix it should be removed.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. G. Cserni (1996) ArticleTitleGastric pathology in Meckel’s diverticulum. Review of cases resected between 1965 and 1995 Am. J. Clin. Pathol. 106 782–785 Occurrence Handle8980355

    PubMed  Google Scholar 

  2. JM. Edmonson (2001) ArticleTitleJohann Friedrich Meckel the younger: Meckel’s diverticulum Gastrointest. Endosc. 54 19A–20A Occurrence Handle10.1053/ge.2001.v54.054101 Occurrence Handle11508254

    Article  PubMed  Google Scholar 

  3. JB Peoples EJ Lichtenberger MM. Dunn (1995) ArticleTitleIncidental Meckel’s diverticulectomy in adults Surgery 118 649–652 Occurrence Handle7570318

    PubMed  Google Scholar 

  4. EK Yahchouchy AF Marano JC Etienne et al. (2001) ArticleTitleMeckel’s diverticulum J. Am. Coll. Surg. 192 658–662 Occurrence Handle10.1016/S1072-7515(01)00817-1 Occurrence Handle11333103

    Article  PubMed  Google Scholar 

  5. DR Andrew KM. Williamson (1994) ArticleTitleMeckel’s diverticulum—rare complications and review of the literature J. R. Army Med. Corps. 140 143–145 Occurrence Handle8822071

    PubMed  Google Scholar 

  6. E Dixon JA. Heine (2000) ArticleTitleIncarcerated Meckel’s diverticulum in a Spigelian hernia Am. J. Surg. 180 126 Occurrence Handle10.1016/S0002-9610(00)00438-4 Occurrence Handle11044527

    Article  PubMed  Google Scholar 

  7. M Dujardin BO Beeck Particlede M. Osteaux (2002) ArticleTitleInverted Meckel’s diverticulum as a leading point for ileoileal intussusception in an adult: case report Abdom. Imaging 27 563–565 Occurrence Handle10.1007/s00261-001-0070-3 Occurrence Handle12172999

    Article  PubMed  Google Scholar 

  8. Fruhauf Ch A Garcia R. Rosso (2002) ArticleTitleStromal tumor in a perforated Meckel’s diverticulum: a case report Swiss Surg. 8 273–276 Occurrence Handle12520847

    PubMed  Google Scholar 

  9. AT Johnston AL Khan R Bleakney et al. (2001) ArticleTitleStromal tumour within a Meckel’s diverticulum: CT and ultrasound findings Br. J. Radiol. 74 1142–1144 Occurrence Handle11777773

    PubMed  Google Scholar 

  10. H Kusumoto H Yoshitake K Mochida et al. (1992) ArticleTitleAdenocarcinoma in Meckel’s diverticulum: report of a case and review of 30 cases in the English and Japanese literature Am. J. Gastroenterol. 87 910–913 Occurrence Handle1615950

    PubMed  Google Scholar 

  11. L Pantongrag-Brown MS Levine PC Buetow et al. (1996) ArticleTitleMeckel’s enteroliths: clinical, radiologic, and pathologic findings A. J. R. Am. J. Roentgenol. 167 1447–1450

    Google Scholar 

  12. A Daneman M Myers B Shuckett et al. (1997) ArticleTitleSonographic appearances of inverted Meckel diverticulum with intussusception Pediatr. Radiol. 27 295–298 Occurrence Handle10.1007/s002470050132 Occurrence Handle9094232

    Article  PubMed  Google Scholar 

  13. N Shindoh A Kurosaki Y Ozaki et al. (1997) ArticleTitleCharacteristic angiographic appearance of inverted Meckel’s diverticulum A. J. R. Am. J. Roentgenol. 169 1569–1571

    Google Scholar 

  14. F Swaniker O Soldes RB. Hirschl (1999) ArticleTitleThe utility of technetium 99m pertechnetate scintigraphy in the evaluation of patients with Meckel’s diverticulum J. Pediatr. Surg. 34 760–765 Occurrence Handle10.1016/S0022-3468(99)90370-6 Occurrence Handle10359178

    Article  PubMed  Google Scholar 

  15. P Aarnio IS. Salonen (2000) ArticleTitleAbdominal disorders arising from 71 Meckel’s diverticulum Am. Chir. Gynaecol. 89 281–284

    Google Scholar 

  16. JF Arnold JV. Pellicane (1997) ArticleTitleMeckel’s diverticulum: a ten-year experience Am. Surg. 63 354–355 Occurrence Handle9124758

    PubMed  Google Scholar 

  17. SH Kashi JP. Lodge (1995) ArticleTitleMeckel’s diverticulum: a continuing dilemma? J R. Coll. Surg. Edinb. 40 392–394

    Google Scholar 

  18. D St-Vil ML Brandt S Panic et al. (1991) ArticleTitleMeckel’s diverticulum in children: a 20-year review J. Pediatr. Surg. 26 1289–1292 Occurrence Handle10.1016/0022-3468(91)90601-O Occurrence Handle1812259

    Article  PubMed  Google Scholar 

  19. LS Miller C Barbarevech LS. Friedman (1994) ArticleTitleLess frequent causes of lower gastrointestinal bleeding Gastroenterol. Clin. North Am. 23 21–52 Occurrence Handle8132299

    PubMed  Google Scholar 

  20. R. Amgwerd (1986) ArticleTitleWhen is a simultaneous operation of Meckel’s diverticulum indicated: always—never—or only in special circumstances? Langenbecks Arch Chir. 369 179–181

    Google Scholar 

  21. G Carstensen W. Hess (1983) ArticleTitleMeckel’s diverticulum—results of 155 resections Langenbecks Arch Chir. 359 161–170 Occurrence Handle10.1007/BF01250978 Occurrence Handle6876995

    Article  PubMed  Google Scholar 

  22. N Demartines U Herzog P Tondelli et al. (1992) ArticleTitleMeckel’s diverticulum: surgical complications Helv. Chir. Acta 59 325–329 Occurrence Handle1428922

    PubMed  Google Scholar 

  23. Y Groebli D Berlin P. Morel (2001) ArticleTitleMeckel’s diverticulum in adults: retrospective analysis of 119 cases and historical review Eur. J. Surg. 167 518–524 Occurrence Handle11560387

    PubMed  Google Scholar 

  24. WA Bemelman E Hugenholtz HA Heij et al. (1995) ArticleTitleMeckel’s diverticulum in Amsterdam: experience in 136 patients World J. Surg. 19 734–737 Occurrence Handle10.1007/BF00295917 Occurrence Handle7571672

    Article  PubMed  Google Scholar 

  25. JC DiGiacomo FJ. Cottone (1993) ArticleTitleSurgical treatment of Meckel’s diverticulum South MedJ. 86 671–675

    Google Scholar 

  26. MM Gottlieb RW Beart SuffixJr. (1995) ArticleTitleSurgical management of Meckel’s diverticulum Ann. Surg 222 770 Occurrence Handle8526592

    PubMed  Google Scholar 

  27. A Koch R Zippel F Marusch et al. (2000) ArticleTitleProspective multicenter study of antibiotic prophylaxis in operative treatment of appendicitis Dig. Surg. 17 370–378 Occurrence Handle10.1159/000018881 Occurrence Handle11053945

    Article  PubMed  Google Scholar 

  28. JJ Cullen KA Kelly CR Moir et al. (1994) ArticleTitleSurgical management of Meckel’s diverticulum An epidemiologic, population-based study. Ann. Surg. 220 564–569

    Google Scholar 

  29. MI Matsagas M Fatouros B Koulouras et al. (1995) ArticleTitleIncidence, complications, and management of Meckel’s diverticulum Arch. Surg. 130 143–146 Occurrence Handle7848082

    PubMed  Google Scholar 

  30. W. Kapral (1988) ArticleTitleMeckel’s diverticulum Pro and co routine removal. Zentralbl. Chir. 113 357–371

    Google Scholar 

  31. A Pinero E Martinez-Barba M Canteras et al. (2002) ArticleTitleSurgical management and complications of Meckel’s diverticulum in 90 patients Eur. J. Surg. 168 8–12 Occurrence Handle10.1080/110241502317307508 Occurrence Handle12022375

    Article  PubMed  Google Scholar 

  32. PR Fa-Si-Oen RM Roumen FA. Croiset Uchelen Particlevan (1999) ArticleTitleComplications and management of Meckel’s diverticulum—a review Eur. J. Surg. 165 674–678 Occurrence Handle10.1080/11024159950189735 Occurrence Handle10452262

    Article  PubMed  Google Scholar 

Download references

Author information

Affiliations

  1. Department of Cardiothoracic and Vascular Surgery, Friedrich-Schiller University, Erlanger-Allee 101, 07747, Jena, Germany

    Torsten Ueberrueck M.D.

  2. Department of Surgery, Carl-Thiem-Hospital, Thiemstr. 111, 03048, Cottbus, Germany

    Lutz Meyer M.D., Andreas Koch M.D., Michael Hinkel M.D., Rainer Kube M.D. & Ingo Gastinger M.D., Ph.D.

Authors
  1. Torsten Ueberrueck M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lutz Meyer M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andreas Koch M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael Hinkel M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rainer Kube M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ingo Gastinger M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Torsten Ueberrueck M.D..

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Ueberrueck, T., Meyer, L., Koch, A. et al. The Significance of Meckel’s Diverticulum in Appendicitis — A Retrospective Analysis of 233 Cases. World J. Surg. 29, 455–458 (2005). https://doi.org/10.1007/s00268-004-7615-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-004-7615-x

Keywords

  • Appendicitis
  • Diverticulitis
  • Intussusception
  • Diagnostic Laparoscopy
  • Postoperative Complication Rate