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Interval Laparoscopic Management of Meckel’s Diverticulitis

Vinay Singhal, MD, Vinayak Sreenivas, MD, S Sainathan, MD, Kamal Nagpal, MD PhD, Daniel Farkas, MD. Bronx Lebanon hospital centre

 

Background

Meckel’s diverticulum is a rare entity. A high degree of suspicion is needed for opportune diagnosis and management. Traditionally patients diagnosed with this entity underwent laparotomy with diverticulectomy or resection of the small intestine. We present a case of meckel’s diverticulitis treated conservatively initially and with interval laparoscopic small bowel resection and intra-corporeal anastamosis.

Case Report

A 64 year old lady presented to the emergency room with right lower quadrant pain, nausea and vomiting. CT scan of the abdomen showed an inflammatory mass in the mid-abdomen with a normal appendix. Meckel’s diverticulitis was suspected. She was treated conservatively with antibiotics. Meckel’s scan and small bowel series done later were suspicious of Meckel’s diverticulum. Patient underwent elective diagnostic laparoscopy and laparoscopic resection of the small bowel with anastamosis. Post- operative course was uneventful and she was discharged on second post-operative day. Laparoscopic resection at the time of initial admission would have been difficult and may have ended up in laparotomy and large resection of multiple involved bowel loops. Interval resection was successfully performed laparoscopically, was small and easy to do with good clinical results.

Conclusion

Interval surgery for meckel’s diverticulitis after management with antibiotics may help avoid laparotomy and may allow the resection to be performed laparoscopically with the attendant benefits of rapid post- operative recovery and reduced morbidity.
 


Session Number: Poster – Poster Presentations
Program Number: P537
View Poster

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