Diverting opinions: surgical debate around method of Meckel's resection.

Abstract

Meckel's diverticulum (MD) is the most common congenital anomaly of the GI tract and can present with obstruction, inflammation or haemorrhage, which requires surgical intervention. Primary malignancies of MD are rare with a reported incidence of 0.5%-3.2%. The standard treatment of symptomatic MDs is resection. However, there is no standard protocol regarding the type of resection. Similarly, for asymptomatic MDs, there is no standard management. We report our experience with a patient in her 60s who required emergent surgery for perforated MD where histology revealed a plexiform fibromyxoma at the junction of the ileum and MD. Current surgical resection techniques for MDs vary from linear or wedge diverticulectomy to segmental bowel resection. This case of an unexpected tumour supports segmental bowel resection in the treatment of MD and raises the question of whether incidental asymptomatic MDs should also be resected due to the risk of tumour or malignancy.