Complications
Can occur from the suture/staple line at the site of an excision of a diverticulum. Patient may present with abdominal pain, fever >101°F (38.3°C), and abdominal tenderness. Treatment is surgical.
Usually occurs during the first 2 postoperative weeks. The incision site develops surrounding erythema, discharge, and tenderness. Treatment involves antibiotics and possible opening of the wound.
Postoperatively, intra-abdominal adhesive disease leading to obstruction may develop over the course of the patient's lifetime. Presentation is with intractable constipation (obstipation), crampy abdominal pain, and vomiting. Plain abdominal x-rays reveal dilated loops of small bowel with air fluid levels and a paucity of gas distally. No prevention is available.
Some have suggested that in patients ages >50 years, an incidental Meckel diverticulum without ectopic tissue should generally be left alone.[4] However, Meckel diverticulum may be a "hot spot" for ileal malignancy, with the risk of malignancy increasing with age.[20] Based on this observation, some have suggested that all incidental Meckel diverticula should be resected, irrespective of age. Further studies are needed to validate this approach, considering that the incidence of Meckel diverticulum-associated ileal malignancy remains very low at 1.44 per 10 million population. Although publications increasingly favor resection, the intraoperative decision should be individualized based on the patient's condition and primary reason for surgery.[45]
The lifetime risk for the development of symptomatic Meckel diverticulum (i.e., bleeding, obstruction, inflammation/perforation) in asymptomatic patients with Meckel diverticulum, where Meckel diverticulum is found incidentally, appears to be between 4% and 6%.[3][24][26][38] Risk factors for the development of symptoms include male sex and age younger than 2 years.
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