Incidence and frequency or complications and management of Meckel's diverticulum

During the last 27 years, 84 patients with Meckel's diverticulum (MD) have undergone resection at our institution (incidental findings, n = 50; MD with complications, n = 34). The most frequent complications of MD were obstruction and diverticulitis. Analysis of records of patients revealed that MD is a rare intraoperative finding. The calculated incidence was 2.4 per cent, and the ratio of diverticulectomy to appendectomy was 1:55. A preoperative diagnosis of MD was rare (4 per cent). Only in those patients with hemorrhage were diagnostic procedures (angiography, scintigraphy and roentgenography) useful. Ectopic tissues occurred in 23 per cent of all patients and were observed more often in patients with complications of MD. There was a correlation between hemorrhage and gastric heterotopic tissue. Another correlation was found between invagination and pancreatic tissue as well as diverticulitis. Postoperative adhesions causing ileus was the main complication found after resection for MD (8 per cent), whereas no other severe complications were observed (no insufficiency). There was no death as a result of resection. Because of the low rate of postoperative complications and the latent risk of complications arising sometime during life in sporadic episodes, a prophylactic resection is indicated but is often performed too late because the primary endangered group for complications is children who are less than two years of age. Predominantly in those with hemorrhage, the base of the diverticulum should be carefully checked for heterotopic tissue to prevent further complications.