Polish pediatric surgeons vary widely in managing incidentally found Meckel's diverticula during appendectomy procedures

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Frontiers in Medicine Published June 4, 2026 Medically reviewed June 4, 2026 DOI ↗ By Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

Key Takeaway

Polish pediatric surgeons lack consensus on managing incidentally found Meckel's diverticula, with excision decisions based on clinical context.

A questionnaire survey and literature review examined management strategies for incidentally diagnosed Meckel's diverticulum in pediatric patients. Eighty-six pediatric surgeons in Poland responded, alongside a review of forty-five English-language articles. The data highlights a lack of consensus regarding the optimal approach to these incidental findings.

Sixty-one percent of respondents routinely search for Meckel's diverticulum during appendectomy. When found, fifty-eight percent of surgeons proceed with excision during the primary operation. However, only seventeen percent choose removal if peritonitis symptoms are present. This suggests clinical judgment heavily influences the decision to operate.

Surgical technique varies by diverticulum characteristics. For narrow bases, surgeons split between wedge or segmental resection and tangential excision. Wide-base diverticula are predominantly treated with wedge or segmental resection. Only twenty-four percent of surgeons are aware of complications from non-radical excision, and fewer than seven percent have personally encountered them.

Reported complications include bleeding from residual ectopic gastric tissue and acute pancreatitis symptoms. Postoperative issues occur infrequently, yet the absence of a standardized protocol persists. Surgeons base their decisions on the specific clinical situation rather than a unified guideline.

Study Details

Study typeGuideline

EvidenceLevel 5

PublishedMay 2026

View Original Abstract ↓

IntroductionThe presence of Meckel's diverticulum is an indication for its surgical removal. However, the procedure for treating incidentally found Meckel's diverticulum is controversial. Is its resection tangential to the intestinal wall using, for example, a surgical stapler sufficient? Should wedge/segmental intestinal resection with end-to-end anastomosis be performed? Is primary diverticulectomy always safe, or should the procedure be postponed and classified as an elective?AimThe objective of the study was to assess the management of incidentally found Meckel's diverticulum based on a questionnaire survey and a literature review.Material and methodsA questionnaire survey was sent to pediatric surgeons in Poland. It included 10 questions about steps taken upon the incidental finding of Meckel's diverticulum during appendectomy and the methods of its treatment. The literature review involved searching PubMed. The analysis included 45 articles published in English.ResultsEighty-six responses were obtained. Sixty-three (61.63%) respondents stated they look for Meckel's diverticulum during each appendectomy. When Meckel's diverticulum is found, 50 (58.14%) respondents excise it during the primary surgery, but in the case of peritonitis symptoms, only 15 (17.44%) respondents choose to remove it. Meckel's diverticulum with a narrow base is excised by wedge or segmental resection by 50 (58.14%) respondents, with a tangential excision with suture closure of the base performed by 35 (40.70%) respondents. According to 76 (88.37%) respondents, Meckel's diverticulum with a wide base is primarily removed by wedge or segmental resection. 21 (24.42%) respondents stated they have heard of complications associated with non-radical Meckel's diverticulum excision and 6 (6.98%) respondents have encountered them in person. Of these 6 cases, 5 involved bleeding from residual ectopic gastric tissue, and 1 case developed symptoms of acute pancreatitis from residual pancreatic tissue.ConclusionsThere is a lack of consensus regarding the management of incidentally diagnosed MD. The decision to proceed with an excision is predicated on the clinical situation. Based on our questionnaire survey, tangential resection is mostly used for long MD with a narrow base. For short MD with a wide base, a safer method seems to be a wedge or rectum section of the intestine. The distinction between the methods results from a high probability of ectopic tissue for MD with a wide base. Postoperative complications occur infrequently, considering all the various operative techniques in use.