Saudi Journal of Gastroenterology
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LETTER TO THE EDITOR Table of Contents   
Year : 2010  |  Volume : 16  |  Issue : 4  |  Page : 306
Asymptomatic Meckel's diverticulum in adults: Is diverticulectomy indicated?


1 Ronak Endo-laparoscopy and General Surgical Hospital, Patan, India
2 General Practitioner, Ahmedabad, Gujarat, India

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Date of Web Publication24-Sep-2010
 

How to cite this article:
Yagnik VD, Yagnik BD. Asymptomatic Meckel's diverticulum in adults: Is diverticulectomy indicated?. Saudi J Gastroenterol 2010;16:306

How to cite this URL:
Yagnik VD, Yagnik BD. Asymptomatic Meckel's diverticulum in adults: Is diverticulectomy indicated?. Saudi J Gastroenterol [serial online] 2010 [cited 2019 Nov 13];16:306. Available from: http://www.saudijgastro.com/text.asp?2010/16/4/306/70626


Sir,

We read the article entitled" Asymptomatic Meckel's diverticulum in adults: Is diverticulectomy indicated?" [1] with interest. We would like to congratulate the authors for conducting a study on such a large number of patients of acute abdomen. The current trend is toward prophylactic diverticulectomy because of the availability of laparoscopy for the management of Meckel's diverticulum. Optimal management of incidentally found Meckel's diverticulum is controversial, even though resection is associated with a low risk of complications. [2] One recent small study recommended prophylactic diverticulectomy in less than 50-years-old individuals. According to one large series, the possibility of a Meckel's diverticulum to become symptomatic in an adult patient is less than 2%, while morbidity rates of incidentally removed Meckel's diverticula were as high as 12% in few studies and 400 asymptomatic diverticula would have to be resected to save one patient. [3] Out of 8 asymptomatic patients in this study, [1] 6 patients (75%) were males and 7 were young < 45 years (87.5%). Though authors have not mentioned about the presence of band and length of diverticulum, from the information available, at least five patients had a risk score [4] of at least 6 and were candidates for resection. We do not agree with the strong recommendation of prophylactic diverticulectomy for all patients as indicated in the present study [1] as sample size is too small (8 patients) to recommend prophylactic diverticulectomy and 12.5% morbidity [1] in such a small study is too high. We believe there is a need for well designed randomized controlled trials to justify prophylactic removal of Meckel's diverticulum, and until the results become available, it would be a better option to remove the diverticulum on the basis of the risk score. [4]

 
   References Top

1.Tauro LF, George C, Rao BS, Martis JJ, Menezes LT, Shenoy HD. Asymptomatic Meckel's diverticulum in adults: Is diverticulectomy indicated? Saudi J Gastroenterol 2010;16:198-202.  Back to cited text no. 1  [PUBMED]  Medknow Journal  
2.Yagnik V, Desai J, Vyas S. Meckel's diverticulum: Report of two cases and review of literature. Internet J Surg 2010. Vol. 22.  Back to cited text no. 2      
3.Soltero MJ, Bill AH. The natural history of Meckel's Diverticulum and its relation to incidental removal. A study of 202 cases of diseased Meckel's Diverticulum found in King County, Washington, over a fifteen year period. Am J Surg 1976;132:168-73  Back to cited text no. 3      
4.Robijn J, Sebrechts E, Miserez M. Management of incidentally found Meckel's Diverticulum a new approach: Resection based on a risk score. Acta Chir Belg 2006;106:467-70.  Back to cited text no. 4      

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Correspondence Address:
Vipul D Yagnik
Ronak Endo-laparoscopy and General Surgical Hospital, Patan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-3767.70626

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