Most patients are asymptomatic. Meckel diverticulum is frequently an incidental finding on radiologic studies or during surgical abdominal exploration.
Given reports of a lifetime risk of 4.2% to 9% for the development of symptomatic Meckel diverticulum (i.e., bleeding, obstruction, inflammation/perforation), some have suggested that Meckel diverticulum found incidentally during abdominal surgery should be resected prophylactically in an attempt to prevent symptoms developing.[1]Hansen CC, Søreide K. Systematic review of epidemiology, presentation, and management of Meckel's diverticulum in the 21st century. Medicine (Baltimore). 2018 Aug;97(35):e12154.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392637
http://www.ncbi.nlm.nih.gov/pubmed/30170459?tool=bestpractice.com
[7]Zani A, Eaton S, Rees CM, et al. Incidentally detected Meckel diverticulum: to resect or not to resect? Ann Surg. 2008 Feb;247(2):276-81.
http://www.ncbi.nlm.nih.gov/pubmed/18216533?tool=bestpractice.com
[8]Ueberrueck T, Meyer L, Koch A, et al. The significance of Meckel's diverticulum in appendicitis--a retrospective analysis of 233 cases. World J Surg. 2005 Apr;29(4):455-8.
http://www.ncbi.nlm.nih.gov/pubmed/15776296?tool=bestpractice.com
[24]Cullen JJ, Kelly KA, Moir CR, et al. Surgical management of Meckel's diverticulum: an epidemiologic, population-based study. Ann Surg. 1994 Oct;220(4):564-8; discussion 568-9.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1234434/pdf/annsurg00056-0170.pdf
http://www.ncbi.nlm.nih.gov/pubmed/7944666?tool=bestpractice.com
However, incidental diverticulectomy as a means of prevention remains controversial, as prophylactic resection is associated with risks and complications. One meta-analysis reported that 758 prophylactic diverticulectomies would need to be performed to prevent one Meckel diverticulum-related death, and concluded that available evidence does not support the resection of incidentally detected Meckel diverticulum.[7]Zani A, Eaton S, Rees CM, et al. Incidentally detected Meckel diverticulum: to resect or not to resect? Ann Surg. 2008 Feb;247(2):276-81.
http://www.ncbi.nlm.nih.gov/pubmed/18216533?tool=bestpractice.com
Although publications increasingly favor resection for asymptomatic Meckel diverticulum discovered intraoperatively, the decision should be individualized based on the patient’s condition and primary reason for surgery.[45]Yagnik VD, Garg P, Dawka S. Should an incidental Meckel diverticulum be resected? A systematic review. Clin Exp Gastroenterol. 2024;17:147-55.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11088382
http://www.ncbi.nlm.nih.gov/pubmed/38736719?tool=bestpractice.com
See Management approach.