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Simple diverticulectomy is adequate for management of bleeding Meckel diverticulum

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Abstract

Purpose

It is unclear whether simple diverticulectomy, rather than segmental bowel resection (SBR), is adequate treatment for gastrointestinal bleeding (GIB) secondary to Meckel diverticulum (MD). There is concern that ulcers in the adjacent bowel may continue to bleed if only the diverticulum is removed. This study seeks to determine if diverticulectomy is satisfactory treatment for bleeding MD.

Methods

A multi-institution, retrospective review was performed for patients with a diagnosis of MD and GIB who underwent simple diverticulectomy or small bowel resection. Exclusion criteria were comorbid surgical conditions and other causes of GIB. The primary outcome was post-operative bleeding during the initial hospitalization. Secondary outcomes were bleeding after discharge, transfusion or additional procedure requirement, re-admission, and overall complications.

Results

There were 59 patients who met study criteria (42 diverticulectomy, 17 SBR). One patient in the SBR group had early post-operative bleeding (p = 0.288). There was one re-admission (p = 0.288) and three total complications in the SBR group (p = 0.021). There were no cases of bleeding or other complications in the diverticulectomy group.

Conclusion

This study suggests that simple diverticulectomy is adequate for treatment of GIB caused by MD. Furthermore, diverticulectomy appears to have a lower overall complication rate.

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Abbreviations

MD:

Meckel diverticulum

GIB:

Gastrointestinal bleeding

SBR:

Small bowel resection

ICD:

International Classification of Disease

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Authors and Affiliations

  1. Department of Surgery, Akron Children’s Hospital, 1 Perkins Sq, Ste 8400, Akron, OH, 44308, USA

    Ian C. Glenn, Nicholas E. Bruns & Todd A. Ponsky

  2. Cohen Children’s Medical Center of New York, 269-01 76th Ave, New Hyde Park, NY, 11040, USA

    Ibrahim Abd el-shafy, Jose M. Prince & Aaron M. Lipskar

  3. Department of Surgery, Children’s Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA

    E. Pete Muenks, Yara K. Duran, Joshua A. Hill & Shawn D. St. Peter

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  1. Ian C. Glenn
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  2. Ibrahim Abd el-shafy
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  3. Nicholas E. Bruns
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Correspondence to Todd A. Ponsky.

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Glenn, I.C., el-shafy, I.A., Bruns, N.E. et al. Simple diverticulectomy is adequate for management of bleeding Meckel diverticulum. Pediatr Surg Int 34, 451–455 (2018). https://doi.org/10.1007/s00383-018-4239-z

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  • DOI: https://doi.org/10.1007/s00383-018-4239-z

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