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[Meckel's diverticulum: surgical complications]
N Demartines1, U Herzog, P Tondelli
1Chirurgische Abteilung, St. Claraspital Basel.
Abstract:
A 20-year (1971-1990) retrospective follow-up of all patients with a Meckel diverticulum (MD) out of the Kantonsspital and St. Claraspital Basel is reported. There were 57 men and 34 women with a mean age of 46.7 years (14-89). 60.4% of the cases were occasional findings, 39.6% were symptomatic MD. During the same period of time 5000 appendectomies were performed (ratio diverticulectomy to appendectomy was 1:50). 38.5% of the resections of MD were done when an acute appendicitis was supposed. In one third of the cases the MD was responsible for the symptomatology. Histological findings were 13% unspecific inflammation, 10% perforation, 9.8% ectopic tissue, 6.5% bleeding and 4.3% tumors. 8 out of 36 patients with pathological findings showed postoperative complications (21.6%), the mortality rate was 8.1%. In 55% resected MD without any additional histological findings only one complication (postoperative ileus) (1.9%) was found; mortality was zero per cent. The analysis of these data shows that complications of MD does not only appear in young patients. Complications occur more often in patients with MD with additional ectopy. We recommend the resection of an incidentally discovered Meckel diverticulum.
Insights
Resecting incidentally found Meckel diverticulum (MD) is recommended, as complications can occur in any age group and are more frequent with ectopic tissue. This study analyzed 20 years of MD cases.
Area of Science:
- Gastroenterology
- Surgical Pathology
Context:
- A 20-year retrospective analysis of Meckel diverticulum (MD) cases from two Swiss hospitals.
- MDs were found incidentally in 60.4% of cases and symptomatic in 39.6%.
- The ratio of diverticulectomies to appendectomies was 1:50.
Purpose:
- To evaluate the clinical presentation, histological findings, and outcomes of Meckel diverticulum (MD) resections.
- To determine the risk factors for complications and mortality associated with MD.
Summary:
- Of 91 patients (57 male, 34 female), 39.6% presented with symptoms. Histological findings included inflammation, perforation, ectopic tissue, bleeding, and tumors.
- Patients with pathological findings had a 21.6% complication rate and 8.1% mortality.
- Resection of incidentally found MDs without pathological findings had a 1.9% complication rate and 0% mortality.
Impact:
- Complications associated with Meckel diverticulum (MD) are not limited to younger patients.
- Patients with MD and ectopic tissue face a higher risk of complications.
- The study recommends resection of incidentally discovered Meckel diverticula to prevent potential complications.