Meckel´s diverticulum in adults – our five-year experience

Česká verzia

Authors: P. Labus; M. Lazorčák; M. Žofčák; M. Kudláč; J. Belák
Authors place of work: II. Chirurgická klinika, UPJŠ, LF, Univerzitná nemocnica L. Pasteura, Košice, prednosta: Doc. MUDr. Jozef Belák, PhD
Published in the journal: Rozhl. Chir., 2012, roč. 91, č. 6, s. 301-304.
Category: Souhrnné sdělení

Summary

Material and methods:
Between 2005 and 2009, 19 patients underwent surgery with an accidental finding of Meckel´s diverticulum (MD) at the Second Department of Surgery in Louis Pasteur University Hospital in Košice. Twelve patients were primarily operated on for acute appendicitis, 3 of them for ileus, 3 patients underwent an elective operation for a gastrointestinal malignity, and in 1 case Meckel’s diverticulum was found during a complicated cholecystectomy. The average age of the patients was 40.4 years (7women and 12 men).

With regard to the accidental finding in the majority of the cases (18), we proceeded radically with diverticulum resection; in 1 case the diverticulum was left in place.

Conclusions:
Meckel´s diverticulum is among the most frequently occurring congenital anomalies of the gastrointestinal tract; in most cases it has an asymptomatic course and its finding is usually accidental during another operation in the abdominal cavity. In such a case it is up to each individual surgeon to consider all the possible risks and complications and decide on an adequate operating procedure according to the abovementioned criteria of authors defining the absolute indication or contraindication for a radical surgical intervention.

Key words:
Meckel´s diverticulum – diverticulitis – invagination

Zdroje

1. Nafisa KK, Yvan JS, Venkata SK. Meckel Diverticulum. [online].[s.a].[citované 19.3.2010]. Dostupné na:

http://emedicine.medscape.com/article/194776-overview.

2. Horn F, Trnka J, Šimičková M, Duchaj B, Makaiová I. Symptomatický Meckelov divertikul u detí. Rozhl Chir 2007;86: 480-482.

3. Krška Z. Meckeluv Divertikl. Čas Lék Čes 2006;145:427–429.

4. Park JJ, Wolff BG, Tollefson MK, Walsh EE, Larson DR. Meckel diverticulum: the Mayo Clinic experience with 1476 patients (1950-2002) Ann Surg 2005;241:529–533.

5. Khaled M, Christine O, Howard J, Isaac R. Imaging Manifestations of Meckel’s Diverticulum. AJR 2007;189,81–88.

6. H. Annamunthodo. Acute complications of Meckels diverticulum. Postgrad Med J. 1955;(351):19–24.

7. Mostbeck GH, Liskutin J, Dorffner R, et al. Ultrasonographic diagnosis of a bleeding Meckel’s diverticulum. Pediatr Radiol 2000;30,382.

8. Paulsen SR, Huprich JE, Fletcher JG, et al. CT enterography as a diagnostic tool in evaluating small bowel disorders: review of clinical experience with over 700 cases. Radio Graphics 2006;26,641–657.

9. Mitchell AW, Spencer J, Allison DJ, et al.,: Meckelęs diverticulum: angiographic findings in 16 patients. AJR 1998;170, 1329–1333.

10. Poulsen KA, Qvist N. Sodium pertechnetate scintigraphy in detection of Meckelęs diverticulum: is it usable? Eur J Pediatr Surg 2000;10:228–231.

11. Dumper J, Mackenzie S, Mitchell P, Sutherland F, Quan ML, Mew D. Complications of Meckelęs diverticula in adults. Can J Surg 2006;49(5),353–7.

12. Miltiadis I, Matsagas MD, Michalis Fatouros MD, Bassilis Koulouras MD, Athanasios D, Giannoukas MD. Incidence, Complications, and Management of Meckelęs Diverticulum. Arch Sur 1995;130(2):143–146.

13. Mackey WC, Dineen P.A fifty year experience with Meckelęs diverticulum. Surg Gynecol Obstet 1983;156:56–64.

14. Ueberrueck T, Meyer L, Koch A, Hinkel M, Kube R, Gastinger I. The significance of Meckelęs diverticulum in appendicitis - a retrospective analysis of 233 cases. World J Surg 2005; 29:455–8.