# 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 · 33 cited statements

## Episodes
### Evidence & Research
- [Journal of Pediatric Surgery Article Review: September 2021](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527) — podcast · 11:16 · [machine version](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527.md)
- [Journal of Pediatric Surgery Article Review: September 2021](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360) — video · 11:16 · [machine version](https://qa.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://qa.library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872) — video · 4:26 · [machine version](https://qa.library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872.md)

## Chapters
- [0:01](https://qa.library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=1) Initial Management After Negative Meckel Scan (Ep 1)
- [1:36](https://qa.library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=96) Surgical Approach and Ulcer Location (Ep 1)
- [3:09](https://qa.library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=189) Laparoscopic Versus Open Technique (Ep 1)
- [0:08](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=8) Early Feeding vs Traditional Feeding After Neonatal Intestinal Anastomosis (Ep 2)
- [5:10](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=310) Clinical Predictive Score for Meckel's Diverticulum (Ep 2)
- [6:53](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=413) Perianal Symptoms and Crohn's Disease in Children (Ep 2)
- [0:00](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=0) Introduction and episode setup (Ep 3)
- [0:44](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=44) Early enteral feeding versus traditional feeding after neonatal intestinal anastomosis (Ep 3)
- [4:36](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=276) Clinical predictive score for Meckel diverticulum in children with hematochezia (Ep 3)
- [6:38](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=398) Perianal symptoms and Crohn disease incidence in children (Ep 3)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- Although there is evidence that early feeding in adult patients after intestinal surgery is beneficial, the Chinese study authors did not find any benefit in neonates. — Mikko Pakarinen (clinical) [Ep 3 · 2:53](https://qa.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 Ponsky (clinical) [Ep 3 · 3:11](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=191)
- The early feeding group was fed through the NG tube left to gravity, not decompressing the stomach after anastomosis. — Todd Ponsky (clinical) [Ep 3 · 3:46](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=226)
- Ponsky concludes that nasogastric tubes are not needed after a baby anastomosis based on the Chinese trial data. — Todd Ponsky (opinion) [Ep 3 · 4:04](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=244)
- Pakarinen states that blood in stool causing a decrease in hemoglobin has always been a red flag sign for Meckel diverticulum in his experience. — Mikko Pakarinen (opinion) [Ep 3 · 5:07](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=307)
- Ponsky would use a high Meckel score to go straight to laparoscopy, skipping the Meckel scan, because even with a negative scan he would still suspect Meckel diverticulum. — Todd Ponsky (opinion) [Ep 3 · 5:40](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=340)
- The Meckel score would help Ponsky potentially skip the Meckel scan in certain subsets of patients, representing a practice change. — Todd Ponsky (opinion) [Ep 3 · 6:20](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=380)
- The Cincinnati perianal Crohn's study included all children aged 0-18 years living within a 15-mile radius of Cincinnati Children's who presented with perianal disease. — Julian Goddard (clinical) [Ep 3 · 8:16](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=496)
- The study also reviewed all children within a 50-mile radius diagnosed with Crohn disease. — Julian Goddard (clinical) [Ep 3 · 8:42](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=522)
- Overall, 3% of children presenting with perianal symptoms were diagnosed with Crohn disease. — Julian Goddard (clinical) [Ep 3 · 9:02](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=542)
- No children under age 1 in the study ended up having Crohn disease within the study period. — Julian Goddard (clinical) [Ep 3 · 9:11](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=551)
- Higher rates of Crohn disease were seen in older children, particularly over age 10. — Iris Limbuel (clinical) [Ep 3 · 9:18](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=558)
- Many patients in the study had fissures, which are very common in children. — Mikko Pakarinen (clinical) [Ep 3 · 9:40](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=580)
- The study included patients whose perianal symptoms were managed as outpatients, who may never have been seen by the surgical team. — Iris Limbuel (clinical) [Ep 3 · 9:54](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=594)
- Ponsky concludes that under age 10, workup for Crohn disease is not needed for perianal symptoms, but over age 10 it should be performed. — Todd Ponsky (opinion) [Ep 3 · 10:06](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=606)
- Ponsky previously thought Crohn disease most commonly presented with GI symptoms like abdominal pain and diarrhea, but learned that quite a few kids present with perirectal abscess. — Todd Ponsky (opinion) [Ep 3 · 10:17](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=617)
- Ponsky has been sending children with perirectal abscess to GI for colonoscopy and has been finding Crohn disease. — Todd Ponsky (clinical) [Ep 3 · 10:27](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=627)
- Although there is evidence that early feeding in adult patients after intestinal surgery is beneficial, the authors didn't find any benefit in neonates — Mikko Pakarinen (clinical) [Ep 2 · 2:37](https://qa.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's diverticulum — Mikko Pakarinen (clinical) [Ep 2 · 5:10](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=310)
- The Cincinnati study included all children aged 0-18 years within a 15-mile radius who presented with perianal disease — Iris Lim Butel (clinical) [Ep 2 · 7:23](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=443)
- Only 3% of children presenting with perianal symptoms were diagnosed with Crohn's disease — Iris Lim Butel (epidemiological) [Ep 2 · 8:51](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=531)
- No children under the age of 1 year with perianal abscess ended up having Crohn's disease within the study period — Iris Lim Butel (epidemiological) [Ep 2 · 9:02](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=542)
- Higher rates of Crohn's disease were seen in older children, particularly over the age of 10 — Julian Goddard (epidemiological) [Ep 2 · 9:16](https://qa.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 — Iris Lim Butel (epidemiological) [Ep 2 · 9:41](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=581)
- Quite a few children with Crohn's disease present with perirectal abscess rather than typical GI symptoms like abdominal pain and diarrhea (clinical) [Ep 2 · 10:23](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=623)
- PPIs can stop bleeding from a Meckel's diverticulum located far down in the GI tract. (clinical) [Ep 1 · 1:00](https://qa.library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=60)
- Bleeding Meckel's diverticulum should never be an emergency operation. (opinion) [Ep 1 · 1:15](https://qa.library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=75)
- If you staple off a bleeding Meckel's diverticulum, the bleeding ulcer is still present and may continue to bleed for the next day. (clinical) [Ep 1 · 2:30](https://qa.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 a vagotomy for a duodenal ulcer. (clinical) [Ep 1 · 2:39](https://qa.library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=159)
- Bleeding from a Meckel's diverticulum is almost always at the tip of the diverticulum. (clinical) [Ep 1 · 2:58](https://qa.library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=178)
- When performing laparoscopic Meckel's resection with stapling, pulling on the diverticulum can distort anatomy and lead to encroachment onto the bowel, potentially causing stricture. (clinical) [Ep 1 · 3:32](https://qa.library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=212)
- Pulling the Meckel's diverticulum out through the umbilicus and marking the resection line without traction helps avoid impinging on the bowel. (clinical) [Ep 1 · 3:32](https://qa.library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=212)
- With a linear staple line across the base of a Meckel's diverticulum, slight impingement on the bowel is not a concern because the bowel will dilate out. (opinion) [Ep 1 · 3:57](https://qa.library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=237)

## Host summaries
Recaps by a host of what the experts said — not the host's own clinical position.
- In the Chinese randomized trial, the early feeding group started feeds at 2 days compared to 6 days for the traditional feeding group. — Ellen Encisco summarizing the discussion [Ep 3 · 2:00](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=120)
- The Chinese trial found 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://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=134)
- The Meckel diverticulum study examined patients under age 18 who presented with hematochezia and determined which presenting factors predict Meckel diverticulum, creating a risk score. — Ellen Encisco summarizing the discussion [Ep 3 · 4:45](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-13360?t=285)
- In the Chinese trial, 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://qa.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://qa.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://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=186)
- The Utah study created a risk score to predict Meckel's diverticulum in patients presenting with hematochezia — Ellen Encisco summarizing the discussion [Ep 2 · 5:10](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=310)
- Todd Ponsky suggests using the Meckel's score to go straight to laparoscopy in high-score patients, skipping the Meckel scan, because even with a negative scan he would still suspect Meckel's diverticulum — Rod Gerardo summarizing the discussion [Ep 2 · 5:10](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=310)
- Under the age of 10, workup for Crohn's disease is not needed in children with perianal symptoms; over age 10, workup should be performed — Rod Gerardo summarizing the discussion [Ep 2 · 10:06](https://qa.library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-september-2021-4527?t=606)
- Bill Gazetta taught that ulcers associated with Meckel's diverticulum are located in the Meckel's itself, not in the adjacent small bowel. — The host summarizing the discussion [Ep 1 · 2:19](https://qa.library.globalcastmd.com/watch/bleeding-meckel-s-diverticulum-update-course-2015-872?t=139)

---
Educational content from recorded physician discussions — not medical advice. Cite the canonical URL or the ?t= deep link. Policy: https://qa.library.globalcastmd.com/ai