Simultaneous resection of a neuroendocrine tumor in an incidental Meckel’s diverticulum with transabdominal preperitoneal hernial repair: a case report

Abstract Background As laparoscopic surgery becomes more prevalent worldwide, Meckel’s diverticula are increasingly being discovered incidentally during surgery. There is no consensus on whether to follow up or resect such diverticula, which are usually asymptomatic. In cases of transabdominal prepe...

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Main Authors: Shoko Kato, Takuya Saito, Shintaro Kurahashi, Yasuyuki Fukami, Shunichiro Komatsu, Kenitiro Kaneko, Tsuyoshi Sano
Format: Article
Language:English
Published: Japan Surgical Society 2024-01-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-024-01821-0
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author Shoko Kato
Takuya Saito
Shintaro Kurahashi
Yasuyuki Fukami
Shunichiro Komatsu
Kenitiro Kaneko
Tsuyoshi Sano
author_facet Shoko Kato
Takuya Saito
Shintaro Kurahashi
Yasuyuki Fukami
Shunichiro Komatsu
Kenitiro Kaneko
Tsuyoshi Sano
author_sort Shoko Kato
collection DOAJ
description Abstract Background As laparoscopic surgery becomes more prevalent worldwide, Meckel’s diverticula are increasingly being discovered incidentally during surgery. There is no consensus on whether to follow up or resect such diverticula, which are usually asymptomatic. In cases of transabdominal preperitoneal inguinal hernia repair, resection of such a diverticulum might add the risk of mesh infection. Thus, it is unclear whether simultaneous intestinal resection is advisable. Case presentation A 64-year-old man diagnosed with a left indirect inguinal hernia underwent laparoscopic inguinal hernia repair, during which a 2-cm Meckel’s diverticulum located contralateral to the mesentery of the ileum approximately 30 cm from Bauhin’s valve was detected incidentally. Because of the potential risk of future complications such as hemorrhage, diverticulitis, or tumor development, wedge resection of the ileum was performed extracorporeally through an extended umbilical port site after completion of the hernia repair. Pathological examination revealed a neuroendocrine tumor (G1) in Meckel’s diverticulum, which was successfully resected without any mesh infection or postoperative complications. Discussion Our patient’s clinical course raises two important issues. First, a Meckel’s diverticulum detected incidentally during laparoscopic surgery should be resected promptly because malignant tumors within such diverticula have frequently been reported. Second, simultaneous resection with hernia repair using mesh seems to be as safe as other clean-contaminated surgery. Conclusions Management of incidental Meckel’s diverticula should be selected by appropriate assessment for the risk of malignancy and complications.
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spelling doaj-art-5ffdd500d5e04bf6a21462b4bb5998ed2025-08-20T03:33:02ZengJapan Surgical SocietySurgical Case Reports2198-77932024-01-011011510.1186/s40792-024-01821-0Simultaneous resection of a neuroendocrine tumor in an incidental Meckel’s diverticulum with transabdominal preperitoneal hernial repair: a case reportShoko Kato0Takuya Saito1Shintaro Kurahashi2Yasuyuki Fukami3Shunichiro Komatsu4Kenitiro Kaneko5Tsuyoshi Sano6Department of Surgery, Aichi Medical UniversityDepartment of Surgery, Aichi Medical UniversityDepartment of Surgery, Aichi Medical UniversityDepartment of Surgery, Aichi Medical UniversityDepartment of Surgery, Aichi Medical UniversityDepartment of Surgery, Aichi Medical UniversityDepartment of Surgery, Aichi Medical UniversityAbstract Background As laparoscopic surgery becomes more prevalent worldwide, Meckel’s diverticula are increasingly being discovered incidentally during surgery. There is no consensus on whether to follow up or resect such diverticula, which are usually asymptomatic. In cases of transabdominal preperitoneal inguinal hernia repair, resection of such a diverticulum might add the risk of mesh infection. Thus, it is unclear whether simultaneous intestinal resection is advisable. Case presentation A 64-year-old man diagnosed with a left indirect inguinal hernia underwent laparoscopic inguinal hernia repair, during which a 2-cm Meckel’s diverticulum located contralateral to the mesentery of the ileum approximately 30 cm from Bauhin’s valve was detected incidentally. Because of the potential risk of future complications such as hemorrhage, diverticulitis, or tumor development, wedge resection of the ileum was performed extracorporeally through an extended umbilical port site after completion of the hernia repair. Pathological examination revealed a neuroendocrine tumor (G1) in Meckel’s diverticulum, which was successfully resected without any mesh infection or postoperative complications. Discussion Our patient’s clinical course raises two important issues. First, a Meckel’s diverticulum detected incidentally during laparoscopic surgery should be resected promptly because malignant tumors within such diverticula have frequently been reported. Second, simultaneous resection with hernia repair using mesh seems to be as safe as other clean-contaminated surgery. Conclusions Management of incidental Meckel’s diverticula should be selected by appropriate assessment for the risk of malignancy and complications.https://doi.org/10.1186/s40792-024-01821-0Meckel’s diverticulumNeuroendocrine tumorTransabdominal preperitoneal repair
spellingShingle Shoko Kato
Takuya Saito
Shintaro Kurahashi
Yasuyuki Fukami
Shunichiro Komatsu
Kenitiro Kaneko
Tsuyoshi Sano
Simultaneous resection of a neuroendocrine tumor in an incidental Meckel’s diverticulum with transabdominal preperitoneal hernial repair: a case report
Surgical Case Reports
Meckel’s diverticulum
Neuroendocrine tumor
Transabdominal preperitoneal repair
title Simultaneous resection of a neuroendocrine tumor in an incidental Meckel’s diverticulum with transabdominal preperitoneal hernial repair: a case report
title_full Simultaneous resection of a neuroendocrine tumor in an incidental Meckel’s diverticulum with transabdominal preperitoneal hernial repair: a case report
title_fullStr Simultaneous resection of a neuroendocrine tumor in an incidental Meckel’s diverticulum with transabdominal preperitoneal hernial repair: a case report
title_full_unstemmed Simultaneous resection of a neuroendocrine tumor in an incidental Meckel’s diverticulum with transabdominal preperitoneal hernial repair: a case report
title_short Simultaneous resection of a neuroendocrine tumor in an incidental Meckel’s diverticulum with transabdominal preperitoneal hernial repair: a case report
title_sort simultaneous resection of a neuroendocrine tumor in an incidental meckel s diverticulum with transabdominal preperitoneal hernial repair a case report
topic Meckel’s diverticulum
Neuroendocrine tumor
Transabdominal preperitoneal repair
url https://doi.org/10.1186/s40792-024-01821-0
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