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Complications and management of Meckel's diverticulum--a review
P R Fa-Si-Oen1, R M Roumen, F A Croiset van Uchelen
1Department of Surgery, Saint Joseph Hospital, Veldhoven, The Netherlands.
Objective:
To review the anatomy, symptomatology, diagnosis, complications and management of symptomatic and asymptomatic Meckel's diverticula.
Design:
Retrospective study.
Setting:
Teaching hospital, The Netherlands.
Subjects:
27 consecutive patients who underwent resection of a Meckel's diverticulum during the 16 year period 1 January 1981-31 August 1997.
Main Outcome Measures:
The symptomatology and histopathological findings.
Results:
15 patients had symptoms and 12 did not. Haemorrhage and inflammation were the most common presenting symptoms. All histopathological signs of inflammation were found in those with symptomatic diverticula. Resected asymptomatic Meckel's diverticula were abnormal in only two occasions: one contained an adenocarcinoma and one a faecolith.
Conclusion:
All symptomatic Meckel's diverticula should be resected. The surgical treatment of asymptomatic Meckel's diverticula is still controversial.
Insights
Symptomatic Meckel
Area of Science:
- Gastroenterology and Surgery
- Congenital Anomalies
- Surgical Pathology
Background:
- Meckel's diverticulum is a congenital anomaly of the small intestine.
- It can be symptomatic or asymptomatic, presenting diagnostic and management challenges.
Purpose of the Study:
- To review the anatomy, symptomatology, diagnosis, complications, and management of Meckel's diverticula.
- To analyze the outcomes of resecting symptomatic versus asymptomatic Meckel's diverticula.
Main Methods:
- Retrospective study conducted at a teaching hospital in The Netherlands.
- Analysis of 27 consecutive patients who underwent Meckel's diverticulum resection between 1981 and 1997.
- Review of symptomatology and histopathological findings.
Main Results:
- 15 patients were symptomatic, 12 asymptomatic. Common symptoms included hemorrhage and inflammation.
- Symptomatic diverticula showed histopathological signs of inflammation.
- Two asymptomatic resections revealed abnormalities: adenocarcinoma and a faecolith.
Conclusions:
- Resection is recommended for all symptomatic Meckel's diverticula.
- The management of asymptomatic Meckel's diverticula remains a subject of debate.