The clinical presentation of Meckel's diverticulum: Eight years experience

梅克尔憩室的临床表现:八年经验

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Abstract

OBJECTIVES: Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract. It is commonly encountered during surgical practice as the cause of the patient's presentation or as an incidental finding during other unrelated procedures. This study aimed to evaluate the frequency of Meckel's diverticulum in our clinical practice and to provide an adequate level of knowledge of the clinical and diagnostic features and the management of Meckel's diverticulum. MATERIAL AND METHODS: We analyzed the medical records of all cases who were diagnosed with Meckel's diverticulum at our hospital for over eight years. Age, sex, presentation, diagnostic procedures, surgical techniques, and histopathology were reviewed and analyzed. RESULTS: A total of 104 patients were enrolled in our study. Mean age was 28.8 years, with male predominance in 92 (88.5%) patients. Symptomatic Meckel's diverticulum was detected in 80 (77%) patients and in 24 (23%) incidental findings. The most common emergency presentation was abdominal pain with 34 patients (42.5%), then intestinal obstruction with 20 patients (25%), bleeding per rectum with 12 patients (15%), acute abdomen with nine patients (11.3%), and intussusception with five patients (6.2%). Mean length of the Meckel's diverticulum was 4.3 centimeters. Small bowel resection was performed in 41 (45.1%) cases, stapled resection in 44 (48.3%), and ligated Meckel's base in 6 (6.4%). Ectopic gastric mucosa was the most common finding in histopathology in 30 (28.8%) patients. CONCLUSION: Our study supports that the longer Meckel's diverticulum is, the more prone it is to developing complications, and stapler resection and small bowel resection are considered safe techniques, as well as resection of incidental Meckel's diverticulum, which does not increase the risk of morbidity.

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