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Acute symptomatic Meckel diverticulum management. Our experience on seven consecutive cases

Umberto Robustelli, Francesco Manguso, Mariano Fortunato Armellino

    Annali Italiani Di Chirurgia
    |June 6, 2014
    PubMed

    Insights

    Meckel's diverticulum, a common gastrointestinal anomaly, often presents with acute symptoms like bleeding or obstruction. Surgical removal is recommended to prevent future complications, including neoplasm.

    Area of Science:

    • Gastroenterology
    • Surgical Pathology
    • Congenital Anomalies

    Background:

    • Meckel's diverticulum is the most frequent congenital anomaly of the gastrointestinal tract.
    • Acute pathologies associated with complicated Meckel's diverticulum necessitate urgent surgical evaluation.

    Observation:

    • A retrospective review of seven patients with complicated Meckel's diverticulum was conducted.
    • Presentations included gastrointestinal hemorrhage (57%), bowel obstruction (29%), and acute appendicitis (14%).
    • Histological examination revealed ectopic mucosa (gastric, pancreatic) in four cases and ulcerated/hemorrhagic areas in one.

    Findings:

    • Diagnosis of complicated Meckel's diverticulum was often incidental, discovered during laparotomy for acute symptoms.
    • Ectopic mucosa, particularly gastric, was a significant finding in complicated cases.
    • Hemorrhage was linked to ulcerated or ectopic mucosal areas within the diverticulum.

    Implications:

    • Prompt surgical resection of Meckel's diverticulum is crucial for managing acute complications.
    • Early diagnosis and intervention can prevent severe outcomes and potential future neoplasms.
    • Simple diverticulectomy at the base is considered the optimal surgical approach.

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