Complicated Meckel's diverticulum and therapeutic management
Varlık Erol, Tayfun Yoldaş, Samet Cin, Cemil Çalışkan, Erhan Akgün, Mustafa Korkut
Department of General Surgery, Ege University Faculty of Medicine, İzmir, Turkey
Objective: In this study we aimed to investigate the treatment options and compare patient management with the literature for patients operated on for an acute abdomen who encountered complications due to inflammation of the Meckels diverticulum in our clinic.
Material and Methods: Between October 2007 and October 2012, 14 patients were retrospectively analysed who had been operated on in the General Surgery Department, Ege University Medical Faculty Hospital, because of an acute abdomen and mechanical intestinal obstruction, and Meckels diverticulitis (MD) was identified as an etiological factor perioperatively and histopathologically.
Results: Fourteen patients were retrospectively analysed who were operated on for Meckels diverticulitis and its complications. Radiologically, in abdominal computed tomography pathologies compatible with mechanical intestinal obstruction, Meckels diverticulitis and peridivertiküler abscess were reported, and free air in the abdomen was detected on direct abdominal X-ray. Fourteen patients were operated on because of complicated Meckels diverticula (obstruction, diverticulitis, perforation) and diverticulum excision was performed on 3 (21.4%) patients; right hemicolectomy + ileotransversostomi was performed on 1 (7.1%) patient and partial small bowel resection and end-to-end anastomosis was performed on 10 (71.5%) patients.
Conclusion: Meckels diverticulum is a vestigial remnant of an omphalomesenteric channel in the small bowel. It is a real congenital diverticular anomaly that contains three layers of the small bowel. If Meckels diverticula are detected, incidental complications may occur such as ulceration, bleeding, bowel obstruction, diverticulitis or perforation, surgical excision should be performed. Meckels diverticulitis does not have specific clinical and radiological findings. Delayed diagnosis can lead to lethal septic complications. Complications associated with Meckels diverticulitis, especially if a definite diagnosis is not reached during the preoperative period, should be considered in the differential diagnosis. The presence of a complicated diverticulum indicates the appropriate approach should be emergency surgical intervention.
Keywords: Small bowel, Meckels diverticulum, treatment
Concept - T.Y., V.E.; Design - T.Y., V.E.; Supervision - T.Y., V.E.; Funding - V.E., T.Y., S.C., C.Ç., E.A., M.K.; Data Collection and/or Processing - V.E., T.Y., S.C.; Analysis and/or Interpretation - V.E., T.Y., C.Ç., E.A., M.K.; Literature Review - V.E., T.Y.; Writer - V.E., T.Y.; Critical Review - C.Ç., E.A., M.K.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.