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Meckel diverticulectomy

Meckel diverticulectomy; Meckel diverticulum - surgery; Meckel diverticulum - repair; GI bleeding - Meckel diverticulectomy; Gastrointestinal bleeding - Meckel diverticulectomy

Meckel diverticulectomy is surgery to remove an abnormal pouch of the lining of the small intestine (bowel). This pouch is called a Meckel diverticulum.

Meckel diverticulum

A Meckel diverticulum is a pouch on the wall of the lower part of the small intestine that is present at birth (congenital). The diverticulum may co...

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Description

You will receive general anesthesia before surgery. This will make you sleep and unable to feel pain.

General anesthesia

General anesthesia is treatment with certain medicines that puts you into a deep sleep so you do not feel pain during surgery. After you receive the...

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If you have open surgery:

Your surgeon will make a large surgical cut in your belly to open up the area.
Your surgeon will look at the small intestine in the area where the pouch or diverticulum is located.
Your surgeon will remove the diverticulum from the wall of your intestine.
Sometimes, the surgeon may need to remove a small part of your intestine along with the diverticulum. If this is done, the open ends of your intestine will be sewn or stapled back together. This procedure is called an anastomosis.
Anastomosis
An anastomosis is a surgical connection between two structures. It usually means a connection that is created between tubular structures, such as bl...
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Surgeons can also do this surgery using a laparoscope. The laparoscope is an instrument that looks like a small telescope with a light and a video camera. It is inserted into your belly through a small cut. Video from the camera appears on a monitor in the operating room. This allows the surgeon to view inside your belly during surgery.

In surgery using a laparoscope:

Three to five small cuts are made in your belly. The camera and other small tools will be inserted through these cuts.
Your surgeon may also make a cut that is 2 to 3 inches (5 to 7.6 cm) long to put a hand through, if needed.
Your belly will be filled with gas to allow the surgeon to see the area and perform the surgery with more room to work.
The diverticulum is operated on as described above.

Why the Procedure Is Performed

Treatment is needed to prevent:

Bleeding
Bowel obstruction (a blockage in your intestine)
Bowel obstruction
Intestinal obstruction is a partial or complete blockage of the bowel. The contents of the intestine cannot pass through it.
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Infection
Inflammation

The most common symptom of Meckel diverticulum is painless bleeding from the rectum. Your stool may contain fresh blood or look black and tarry.

Risks

Risks for anesthesia and surgery in general are:

Allergic reactions to medicines or breathing problems
Breathing problems
Breathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough air
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Bleeding, blood clots, or infection
Bleeding
Bleeding is the loss of blood. Bleeding may be:Inside the body (internal)Outside the body (external)Bleeding may occur:Inside the body when blood le...
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Blood clots
Blood clots are clumps that occur when blood hardens from a liquid to a solid. A blood clot that forms inside one of your veins or arteries is calle...
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Risks for this surgery are:

Damage to nearby organs in the body.
Wound infections or the wound breaks open after surgery.
Bulging tissue through the surgical cut. This is called an incisional hernia.
The edges of your intestines that are sewn or stapled together (anastomosis) may come open.
The area where the intestines are sewn together can scar and create blockage of the intestine.
Blockage of the intestine may occur later from adhesions caused by the surgery.
Adhesions
Adhesions are bands of scar-like tissue that form between two surfaces inside the body and cause them to stick together.
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Before the Procedure

Tell your surgeon:

If you are or could be pregnant
What medicines you are taking, even medicines, supplements, or herbs you bought without a prescription

During the days before your surgery:

You may be asked to stop taking blood thinners. These include NSAIDs (aspirin, ibuprofen), vitamin E, warfarin (Coumadin), dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), and clopidogrel (Plavix).
Ask your doctor which drugs you should still take on the day of the surgery.
If you smoke, try to stop. Ask your health care provider for help quitting.

On the day of your surgery:

Follow your doctor's instructions about when to stop eating and drinking.
Take the medicines you were told to take with a small sip of water.
Arrive at the hospital on time.

After the Procedure

Many people stay in the hospital for 1 to 7 days depending on how extensive the surgery was. During this time, the provider will carefully monitor you.

Treatment may include:

Pain medicines
Tube through your nose into your stomach to empty your stomach and relieve nausea and vomiting

You will also be given fluids through a vein (IV) until your provider feels you are ready to start drinking or eating. This could be as soon as the day after surgery.

You will need to follow-up with your surgeon in a week or two after surgery.

Outlook (Prognosis)

Many people who have this surgery have a good outcome. But the results of any surgery depend on your overall health. Talk with your doctor about your expected outcome.

Open References

References

Fransman RB, Harmon JW. Management of diverticulosis of the small bowel. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:143-145.

Gan T, Evers BM. Small intestine. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis MO: Elsevier; 2022:chap 50.

Meckel's diverticulectomy - normal anatomy

Presentation

<strong>Meckel's diverticulectomy - normal anatomy</strong><p>The small intestine is the longest portion of the digestive tract. It runs from the stomach to the colon.</p>

<strong>Indications</strong><p>Meckel's diverticulum is one of the most common congenital abnormalities. It occurs when the connection between the intestine and the umbilical cord doesn't completely close off during fetal development. This results in a small outpouching of the small intestine, know as a Meckel's diverticulum. In most cases, Meckel's diverticula do not cause any problems. In a small number of patients however, these diverticula can become infected (diverticulitis) cause an obstruction of the intestine, or cause bleeding from the intestine. The most common symptom of Meckel's diverticulitis is painless bleeding from the rectum. The stools may contain fresh blood or may look black and tarry. Diverticulitis, or infection, of a Meckel's diverticulum is often mistaken for appendicitis.</p>

<strong>Incision</strong><p>Treatment of a Meckel's diverticulum involves resection of the involved portion of the small intestine. Often, symptoms from a Meckel's diverticulum are thought to be due to appendicitis and the Meckel's diverticulum is discovered only after the operation has begun. While the patient is deep asleep and pain-free (general anesthesia), an incision is made in the right side of the lower abdomen.</p>

<strong>Procedure</strong><p>The small intestine is found and the Meckel's diverticulum is removed. The intestine is repaired and the incision is closed.</p>

<strong>Aftercare</strong><p>Intravenous fluids will be given until the patient is able to eat by mouth (after bowel sounds are heard). A nasogastric tube may be in place to empty the stomach. Antibiotics may be given to prevent or treat infection. Discharge from the hospital can be expected within a week after surgery, barring complications.</p>

Meckel's diverticulectomy - normal anatomy

Presentation

Review Date: 8/22/2022

Reviewed By: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Meckel diverticulectomy

Meckel diverticulum

Description

General anesthesia

Anastomosis

Why the Procedure Is Performed

Bowel obstruction

Risks

Breathing problems

Bleeding

Blood clots

Adhesions

Before the Procedure

After the Procedure

Outlook (Prognosis)

References

Meckel's diverticulectomy - normal anatomy

Meckel's diverticulectomy - normal anatomy

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