Surgical management of Meckel's diverticulum. An epidemiologic, population-based study.

Abstract

The authors determined whether Meckel's diverticulum, discovered incidentally at operation, should be removed. It is not clear from the medical literature whether the risk of an incidental Meckel's diverticulectomy is greater than the risk of leaving the diverticulum in place. The authors used the medical experience of Olmsted County, Minnesota residents for the period 1950 to 1992 to answer the question. During the period, 58 residents developed Meckel's complications that required diverticulectomies. The incidence of complications was 87 per 100,000 person-years, and the lifetime risk (to 80 years of age) of developing them was 6.4%. The risks were similar throughout the period and at all ages of life, but were greater among men (124 per 100,000 person-years) than women (50 per 100,000 person-years, p < 0.05). Diverticulectomies for complications carried an operative mortality and morbidity of 2% and 12% and a cumulative risk of long-term postoperative complications of 7%, whereas incidental diverticulectomies done in 87 residents during the period carried corresponding rates of only 1%, 2%, and 2%, respectively. Meckel's diverticula discovered incidentally at operation should be removed for most patients, regardless of age.