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[Meckel diverticulum as a possible source of complications]
Abstract:
The authors performed a retrospective analysis of 108 operations performed because of Meckel's diverticulum from Jan. 1, 1980 until Dec. 31, 1997. 87 incidental operations were performed (80.55%) and 21 operations were performed (19.54%) because of complications of Meckel's diverticulum. Of the 87 incidental cases, 44 were males and 43 were females. The diverticulum was resected in 70 cases, was inverted in 16 patients and was left untouched in 1 patient. There were postoperative complications in 10 cases (11.5%), however, only one complication was related to the diverticulum operation. There was one death due to pneumonia in the incidental group (1.14%). Of the 21 cases having complications there were 5 females and 16 males. The following complications were observed: 4 cases of ileus, 7 cases of perforation (a foreign body was found in two cases) and 10 cases of inflammation. The Meckel's diverticulum was resected in 19 cases and the small intestine was resected in 2 cases. Postoperative complications occurred in 3 cases (14.3%), however these were not related to the diverticulum operations. There were 2 deaths due to pneumonia and pulmonary embolism (9.5%). Histological examination revealed 7 cases of heterotopic gastric mucosa in both the incidental group and the group with complications. There was one case of heterotopic pancreatic tissue in the group with complications. The incidence of heterotopy in the incidental group was 8%, whereas in the group with complications the incidence was 33.3%. Histological examination also revealed reflux gastritis-like diverticulitis in 5 of the patients with heterotopic gastric mucosa. Meckel's diverticulum was diagnosed in 2 patients preoperatively by upper gastrointestinal series.
Insights
This study analyzed 108 Meckel
Area of Science:
- Gastroenterology
- Surgical Pathology
- Clinical Surgery
Background:
- Meckel's diverticulum is a congenital anomaly of the small intestine.
- It can be asymptomatic or present with complications.
- Understanding its presentation and outcomes is crucial for surgical management.
Purpose of the Study:
- To analyze the clinical presentation, surgical management, and outcomes of patients with Meckel's diverticulum.
- To investigate the association between heterotopic tissue and complications.
Main Methods:
- Retrospective analysis of 108 operations for Meckel's diverticulum between 1980 and 1997.
- Categorization into incidental and complicated cases.
- Review of surgical procedures, postoperative complications, and histological findings.
Main Results:
- 80.55% of operations were for incidental Meckel's diverticulum, while 19.54% were for complications.
- Complications included ileus, perforation, and inflammation.
- Heterotopic tissue (gastric mucosa, pancreatic tissue) was found in 8% of incidental cases and 33.3% of complicated cases.
- Reflux gastritis-like diverticulitis was observed in patients with heterotopic gastric mucosa.
Conclusions:
- Meckel's diverticulum management varies, with a higher incidence of complications in males.
- The presence of heterotopic tissue, particularly gastric mucosa, is associated with a higher risk of complications.
- Early diagnosis and appropriate surgical intervention are essential for favorable outcomes.