# Meckel's Diverticulum — GCMD Library living collection

Everything in the library about Meckel's diverticulum — built automatically from dossiers that name it.

Updated: n/a · 3 episodes · 32 cited statements

## Episodes
### Evidence & Research
- [Journal of Pediatric Surgery Article Review: September 2021](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527) — podcast · 11:16 · [machine version](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527.md)
- [Journal of Pediatric Surgery Article Review: September 2021](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360) — video · 11:16 · [machine version](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360.md)

### Case-Based Learning
- [Bleeding Meckel's Diverticulum: Update Course 2015](https://origin-library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872) — video · 4:26 · [machine version](https://origin-library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872.md)

## Chapters
- [0:01](https://origin-library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=1) Diagnostic approach after negative Meckel scan (Ep 1)
- [1:36](https://origin-library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=96) Surgical management of bleeding Meckel's diverticulum (Ep 1)
- [3:09](https://origin-library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=189) Laparoscopic versus open technique for Meckel's resection (Ep 1)
- [0:08](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=8) Early feeding versus traditional feeding after neonatal intestinal anastomosis and Meckel diverticulum predictive score (Ep 2)
- [6:53](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=413) Perianal symptoms and Crohn disease incidence in children (Ep 2)
- [0:00](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=0) Introduction and Episode Setup (Ep 3)
- [0:44](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=44) Early Enteral Feeding vs Traditional Feeding in Neonatal Intestinal Anastomosis (Ep 3)
- [4:36](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=276) Clinical Predictive Score for Meckel's Diverticulum (Ep 3)
- [6:38](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=398) Perianal Symptoms and Crohn's Disease in Children (Ep 3)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- PPI therapy will stop bleeding from a Meckel's diverticulum. (clinical) [Ep 1 · 1:15](https://origin-library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=75)
- Bleeding Meckel's diverticulum should never be an emergency operation. (opinion) [Ep 1 · 1:15](https://origin-library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=75)
- After stapling off a Meckel's diverticulum, the bleeding ulcer is still present and the patient may continue bleeding for the next day. (clinical) [Ep 1 · 2:30](https://origin-library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=150)
- Removing the Meckel's diverticulum eliminates the source of acid causing the ulcer, analogous to performing vagotomy for duodenal ulcer. (clinical) [Ep 1 · 2:39](https://origin-library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=159)
- The bleeding ulcer is almost always at the tip of the Meckel's diverticulum. (clinical) [Ep 1 · 2:58](https://origin-library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=178)
- When stapling a Meckel's diverticulum laparoscopically, pulling it up to staple creates a tendency to encroach onto the bowel. (clinical) [Ep 1 · 3:32](https://origin-library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=212)
- Pulling a Meckel's diverticulum out through the umbilicus and marking the resection line without tension prevents distortion of anatomy. (clinical) [Ep 1 · 3:32](https://origin-library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=212)
- With a linear staple line across a Meckel's base, slight impingement on the bowel does not matter because the bowel will dilate out, unless a huge stricture is created. (clinical) [Ep 1 · 3:57](https://origin-library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=237)
- Although there is evidence that early feeding in adult patients after intestinal surgery is beneficial, the authors did not find any benefit in neonates. — Mick Kakaran (clinical) [Ep 2 · 2:37](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=157)
- Babies with blood in their stool causing a decrease in hemoglobin has always been a red flag sign for Meckel diverticulum. — Mick Kakaran (clinical) [Ep 2 · 3:06](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=186)
- A Cincinnati Children's study examined children aged 0-18 within a 15-mile radius who presented with perianal symptoms (abscess, fissure, fistula) to determine how often this represents Crohn disease. — Iris Lim Butel (clinical) [Ep 2 · 7:23](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=443)
- Overall, 3% of children presenting with perianal symptoms were diagnosed with Crohn disease. — Iris Lim Butel (epidemiological) [Ep 2 · 9:02](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=542)
- No children under age 1 with perianal abscess ended up having Crohn disease within the study period. — Iris Lim Butel (epidemiological) [Ep 2 · 9:02](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=542)
- Higher rates of Crohn disease were seen in older children, particularly over age 10, among those presenting with perianal symptoms. — Julian Goddard (epidemiological) [Ep 2 · 9:16](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=556)
- Many patients in the study had fissures, which are very common in children and may have been managed as outpatients. — Iris Lim Butel (clinical) [Ep 2 · 9:41](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=581)
- Quite a few children with Crohn disease present with perirectal abscess rather than typical GI symptoms like abdominal pain and diarrhea. (clinical) [Ep 2 · 10:23](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=623)
- Although there is evidence that early feeding in adult patients after intestinal surgery is beneficial, the authors didn't find any benefit in neonates (clinical) [Ep 3 · 2:53](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=173)
- In the early feeding group, patients did not have a decompressing nasogastric tube — Todd (clinical) [Ep 3 · 3:11](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=191)
- Nasogastric decompression is not needed after an anastomosis in neonates — Todd (opinion) [Ep 3 · 3:19](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=199)
- The two groups had the same outcomes despite one group not having NG decompression, indicating NG tubes are not necessary after baby anastomosis — Todd (clinical) [Ep 3 · 3:55](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=235)
- Babies with blood in their stool enough to cause a decrease in hemoglobin is a red flag sign for Meckel's diverticulum (clinical) [Ep 3 · 5:07](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=307)
- If the Meckel's predictive score is high, one could go straight to laparoscopy because even with a negative Meckel scan, it's likely a Meckel's diverticulum — Todd (opinion) [Ep 3 · 5:40](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=340)
- The Meckel's score could help tip the scale of skipping the Meckel scan in certain subset of patients — Todd (opinion) [Ep 3 · 6:17](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=377)
- The Cincinnati study included all children from 0 to 18 years who lived within a 15 mile radius of Cincinnati Children's and presented with perianal disease — Julian Goddard (clinical) [Ep 3 · 8:16](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=496)
- A second cohort included all children within a 50 mile radius who were diagnosed with Crohn's disease — Julian Goddard (clinical) [Ep 3 · 8:42](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=522)
- Overall, 3% of children presenting with perianal symptoms ended up being diagnosed with Crohn's disease — Julian Goddard (clinical) [Ep 3 · 9:02](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=542)
- No children under the age of 1 had Crohn's disease within the study period — Julian Goddard (clinical) [Ep 3 · 9:11](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=551)
- Higher rates of Crohn's disease are seen in older children, particularly over the age of 10 — Iris Limbuel (clinical) [Ep 3 · 9:18](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=558)
- The study included patients who had their perianal symptoms dealt with as an outpatient, who may not have been seen by the surgical team — Iris Limbuel (clinical) [Ep 3 · 9:54](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=594)
- Under the age of 10, you do not need to worry about doing a workup for Crohn's disease in children with perianal symptoms — Todd (opinion) [Ep 3 · 10:06](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=606)
- Over the age of 10, you should do a workup for Crohn's disease in children with perianal symptoms — Todd (opinion) [Ep 3 · 10:14](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=614)
- Quite a few children with Crohn's disease present with a perirectal abscess rather than GI symptoms like abdominal pain or diarrhea — Todd (clinical) [Ep 3 · 10:17](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=617)

## Host summaries
Recaps by a host of what the experts said — not the host's own clinical position.
- Bill Gazetta taught that the ulcers in bleeding Meckel's diverticulum are located within the Meckel's itself, not in the adjacent small bowel. — The host summarizing the discussion [Ep 1 · 2:19](https://origin-library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=139)
- A Chinese randomized multi-center trial of 156 neonates who underwent surgery for gastrointestinal malformation with intestinal anastomosis compared early internal feeding versus traditional nasogastric decompression. — Rod Gerardo summarizing the discussion [Ep 2 · 0:44](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=44)
- The early feeding group started feeds at 2 days compared to 6 days in the traditional feeding group. — Rod Gerardo summarizing the discussion [Ep 2 · 0:44](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=44)
- There was no significant difference between early and traditional feeding groups in length of stay, time to full feeds, postoperative complications, 30-day mortality, or 30-day readmissions. — Rod Gerardo summarizing the discussion [Ep 2 · 0:44](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=44)
- In the early feeding group, patients did not have a decompressing nasogastric tube, suggesting nasogastric decompression is not needed after neonatal intestinal anastomosis. — Rod Gerardo summarizing the discussion [Ep 2 · 3:06](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=186)
- A Utah study examined patients under age 18 who presented with hematochezia to identify which factors predict Meckel diverticulum and created a risk score. — Rod Gerardo summarizing the discussion [Ep 2 · 3:06](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=186)
- The Meckel score could help clinicians skip the Meckel scan and go straight to laparoscopy in high-score patients, even with a negative scan. — Rod Gerardo summarizing the discussion [Ep 2 · 3:06](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=186)
- Under age 10, clinicians do not need to worry about doing a workup for Crohn disease in children with perianal symptoms; over age 10, they should. — Rod Gerardo summarizing the discussion [Ep 2 · 10:06](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=606)
- In the Chinese study, the early feeding group started feeds at 2 days compared to 6 days for the traditionally fed group — Ellen Encisco summarizing the discussion [Ep 3 · 2:00](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=120)
- There was no significant difference between early and traditional feeding groups in length of stay, time to full feeds, postoperative complications, 30-day mortality, or 30-day readmissions — Ellen Encisco summarizing the discussion [Ep 3 · 2:14](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=134)

## Changelog
- Sep 25: 3 items added automatically

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