Meckel’s Diverticulum Causing Ileal Volvulus and Peritonitis after a Recent Appendectomy: A Case Report and Literature Review—We Should Likely Resect an Incidental MD
Abstract
:1. Introduction
2. Case Presentation
3. Materials and Methods
4. Results
5. Discussion
6. Conclusions
Author Contributions
Funding
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Author | Year | Conclusion |
---|---|---|
Weinstein et al. [19] | 1962 | Wide-mouthed MD were not considered dangerous, and therefore their resection would only add to the risk of surgical complications and do not provide any benefit. |
Soltero and Bill [20] | 1976 | To save one patient’s life from the complications of MD, it would be necessary to remove approximately 800 asymptomatic MDs. This would be likely to incur a significant increase in postoperative morbidity. They suggest that the prophylactic removal of MD is rarely, if ever, justified. |
Leijonmarck et al. [12] | 1986 | In adults, an incidentally discovered, symptomless MD should be left in place. |
Peoples et al. [21] | 1995 | Incidental diverticulectomy in adults should be abandoned. |
Stone et al. [22] | 2004 | Removal of asymptomatic MD, particularly in women, is not recommended. |
Zani et al. [18] | 2008 | 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. |
Author | Year | Conclusion |
---|---|---|
Mackey et al. [23] | 1983 | Recommend resection when risk factors are present: age ≤ 40 years, length of the diverticulum ≥ 2 cm, presence of heterotopic tissue, and male sex. |
Vane et al. [24] | 1987 | Resection of asymptomatic vitelline remnants in early childhood is reasonable at the time of laparotomy for other conditions. |
St-Vil et al. [25] | 1991 | MD discovered incidentally should be resected if ectopic mucosa present or if attached to the umbilicus or to the mesentery by fibrous bands. |
DiGiacomo et al. [26] | 1993 | Stapler diverticulectomy is appropriate and safe and should be done for diverticula that easily fit the device. Diverticula that are so broad-based or short that stapled excision cannot be easily accomplished should be left in situ, since they are at low risk for complications. |
Cullen et al. [27] | 1994 | Recommend prophylactic resection regardless of age (providing no additional condition, such as generalized peritonitis, would make removal hazardous). |
Matsagas et al. [28] | 1995 | Resection of the unexpected MD can be performed safely with a low complication rate, regardless of the patient’s age. |
Chiu et at. [29] | 2000 | The small bowel diverticula, except for MD, do not need to be treated if there are no significant symptoms. |
Groebli et al. [30] | 2001 | The criteria to resect incidental MD: male sex, age < 40, ASA score, the operation being performed, size and position of the MD, palpable mass, exploration for acute right lower quadrant pain showing no other abnormality. |
Onen et al. [31] | 2003 | Resection of the MD is recommended in all children younger than 8 years, including asymptomatic ones, in the absence of absolute contraindications. |
Bani-Hani et al. [32] | 2004 | Resection of incidentally found MD is not associated with increased operative morbidity or mortality. |
Park et al. [14] | 2005 | Recommend removal when risk factors are present: age < 50 years, male sex, diverticulum > 2 cm, and the presence of histologically abnormal tissue. |
Ueberrueck et al. [33] | 2005 | 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. |
Dumper et al. [34] | 2006 | Criteria to resect incidental MD: younger age at presentation, narrow diverticular neck, previous abdominal adhesions or obstructions, and any palpable or visual abnormality of the diverticulum. |
Robijn et al. [35] | 2006 | Recommend resection with a Risk Score ≥ 6. Risk factors of the score: male sex, patients < 45 years, MD >2 cm, and the presence of a fibrous band. |
McKay [36] | 2007 | Recommend prophylactic resection in patients under 50 years of age. |
Zulfikaroglu et al. [37] | 2008 | Recommend prophylactic resection because it is not associated with increased operative morbidity or mortality. |
Thirunavukarasu et al. [38] | 2011 | MD is a high-risk area for cancer in the ileum. With risk that increases with age and high possibility of curative resection with negligible operative mortality, incidental MD is best treated with resection. |
Caracappa et al. [39] | 2014 | Recommend prophylactic resection. |
Kilius et al. [40] | 2015 | Recommend prophylactic resection. |
Jadlowiec et al. [41] | 2015 | Recommend prophylactic resection in patients of all ages. |
Gezer et al. [42] | 2016 | Recommend prophylactic resection regardless of its macroscopic appearance. |
Lequet et al. [43] | 2017 | Recommend resection when risk factors are present: male sex, age ≤ 40 years, diverticulum length > 2 cm, and presence of macroscopically mucosal alteration noted at surgery. |
Blouhos et al. [44] | 2018 | Recommend resection when risk factors are present: age < 50 years, male sex, diverticulum length > 2 cm, and ectopic or abnormal features within a diverticulum. Diverticulectomy should be performed for long MD and wedge resection for short MD. |
Chen et al. [11] | 2018 | Heterotopic tissue is the main cause of a complicated diverticulum, and it is safe and feasible to remove the incidentally found MD. |
Hansen et al. [1] | 2018 | Incidental MD should always be resected in the pediatric population and in the presence of risk factors in the adult population. |
Mora-Guzmán et al. [45] | 2018 | Recommend prophylactic resection because the benefits of resection of this high-risk area for cancer outweigh the risks of surgery. |
Mora-Guzmán et al. [46] | 2018 | Recommend prophylactic resection of incidentally found MD because of benefits outweighing the risks in this high-risk area for cancer. |
Demirel et al. [47] | 2019 | Recommend prophylactic resection due to the risk of ectopic tissue that may cause a mass effect or a narrow neck that may predispose to obstruction and diverticulitis. |
Chen et al. [48] | 2021 | Recommend prophylactic resection when MD is longer, with a fibrous band at the tip of the diverticulum and a narrow base. |
Tree et al. [49] | 2023 | Recommend laparoscopic prophylactic resection. |
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Zanchetta, M.; Inversini, D.; Pappalardo, V.; Grappolini, N.; Morabito, M.; Gianazza, S.; Carcano, G.; Ietto, G. Meckel’s Diverticulum Causing Ileal Volvulus and Peritonitis after a Recent Appendectomy: A Case Report and Literature Review—We Should Likely Resect an Incidental MD. Life 2023, 13, 1996. https://doi.org/10.3390/life13101996
Zanchetta M, Inversini D, Pappalardo V, Grappolini N, Morabito M, Gianazza S, Carcano G, Ietto G. Meckel’s Diverticulum Causing Ileal Volvulus and Peritonitis after a Recent Appendectomy: A Case Report and Literature Review—We Should Likely Resect an Incidental MD. Life. 2023; 13(10):1996. https://doi.org/10.3390/life13101996
Chicago/Turabian StyleZanchetta, Matteo, Davide Inversini, Vincenzo Pappalardo, Niccolo Grappolini, Marika Morabito, Simone Gianazza, Giulio Carcano, and Giuseppe Ietto. 2023. "Meckel’s Diverticulum Causing Ileal Volvulus and Peritonitis after a Recent Appendectomy: A Case Report and Literature Review—We Should Likely Resect an Incidental MD" Life 13, no. 10: 1996. https://doi.org/10.3390/life13101996