A wide mouth meckels diveiculum is found. accidently on laparotomy. what will be t/t of choice?
Ans is 'b' ie leave it as such "A wide-mouthed, thin walled unattached diveiculum in an adult patient can probably quite safely be left alone." - Maingot's Treatment Any symptomatic Meckel's diveicula is resected (Diveiculectomy) There are two techniques for excision of the diveiculum - simple excision resection with the segment of ileum containing the diveiculum and then reanastomosis. Resection of ileum with reanastomosis is reserved for patients with peptic ulceration in the ileal mucosa a gangrenous diveiculitis affecting the base of the diveiculum if the base of the diveiculum is inflamed or perforated in rare cases of malignant disease situated in Meckel's diveiculum. Management of asymptomatic Meckel's diveicula found incidentally on laprotomy Management is controversial and different books write differently. According to Maingot's - a wide-mouthed, thin walled Meckel's diveiculum without any attached band can be left. - prophylactic diveiculectomy is done - if the diveicula has a narrow base if there is any palpable thickening or adhesions suggestive of ectopic tissue. - if there is any attachment either by bands to the umbilicus or by a mesodiveicular vascular strand.
Resection of diveiculum
Leave as such
Ligate at base
Resection withpa of ileum