Use of Meckel’s diverticulum as a temporary diverting ostomy. Ann Ital Chir - Epub 2020, 9 - May 25 1 Ann Ital Chir, Digital Edition 2020, 9 pii: S2239253X20032119 - Epub, May 25 free reading: www.annitalchir.com Pervenuto in Redazione Dicembre 2019. Accettato per la pubblicazione Gennaio 2020 Correspondence to: Denis A. Cozzi, MD, Associate Professor of Pediatric Surgery, Sapienza University of Rome, and Head of the Pediatric Surgery Unit, Azienda Ospedaliero Universitaria Policlinico Umberto I, Viale Regina Elena, 324, 00161 Rome, Italy (e-mail: da.cozzi@uniroma1.it) Silvia Ceccanti*, Alice Cervellone*, Maria Vittoria Pesce**, Silvia Piacenti*, Denis A. Cozzi* *Pediatric Surgery Unit, Sapienza University of Rome, Azienda Policlinico Umberto I, Rome, Italy **Department of Anesthesia and Critical Care Medicine, Azienda Policlinico Umberto I, Rome, Italy Use of Meckel’s diverticulum as a temporary diverting ostomy Meckel’s diverticulum is among the most common congenital defects of the gastrointestinal tract, and is associated with a total lifetime risk of complications around 4%. While debate on prophylactic resection of incidental Meckel’s diverticulum continues, there have been reports of its successful use for urinary diversion and reconstruction. In contrast, its use as a means of fecal diversion has been described anecdotally. Herein, we describe our technique of temporary fecal diversion using Meckel’s diverticulum as reliable conduit for stoma formation in a toddler. Te stoma functioned well until continuity of bowel was restored and diverticulum resected safely. We trust that our limited experience will encourage other colleagues to test the inventive use of Meckel’s diverticulum as a potentially safe and efective option to ft in the surgical arma- mentarium for temporary fecal diversion. KEY WORDS: Anastomotic leak, Fecal diversion, Ileostomy, Meckel’s diverticulum, Stoma was frst described by the German surgeon Wilhelm Fabricius Hildanus 1 , the surgical management of this bizarre anatomical structure is still intriguing both adult and pediatric surgeons 2 . Current mortality from MD has been estimated to be below 1%, with large propor- tion of deaths occurring in the pediatric age 2 . Te total lifetime complication rate has been reported to be around 4%, with bleeding from ectopic tissue and intestinal obstruction being the most common presentations. While the debate about the need to excise an asymptomatic MD continues, some colleagues have successfully chal- lenged the use of MD as a suitable and reliable conduit for urinary and fecal diversion. Herein, we describe the use of MD for temporary fecal diversion in a toddler born with multiple gastrointesti- nal malformations. Case Report Te patient was a 20–month old boy born with multi- ple malformations including type-C esophageal atresia, perforated duodenal web, and recto-prostatic fstula. Introduction Meckel’s diverticulum (MD) is considered the most pre- valent congenital anomaly of the gastrointestinal tract, afecting about 2% of the general population. Nonetheless, the old adage ascribed to the famous American surgeon Dr. Charles William Mayo is still valid: MD is frequently suspected, often looked for, and seldom found. Tis is a congenital true diverticulum that results from an incomplete obliteration of the vitelline duct occur- ring during the ffth week of gestation. Almost invariably MD arises as an outpouching along the antimesenteric border of the terminal ileum at a distance varying from 45 to 90 cm proximal to the ileocecal valve. Despite more than 4 centuries have passed since MD Digital Edition e-publish on-line ISSN 2239-253X Direttore Nicola Picardi READ-ONLY COPY PRINTING PROHIBITED