Related Experiment Videos
[Meckel's diverticulum. Personal experience]
F Natta1, E Passarelli, M V Rosso
1Regione Piemonte, USSL n. 36, Presidio Ospedaliero di Susa, Torino.
Abstract:
Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, occurring in 1-3% of autoptic studies. It's remnant of the omphalomesenteric duct which connects the primitive gut to the yolk sac in early fetal life and the failure of obliteration may result in an omphalomesenteric fistula, an enterocyst, a fibrous band connecting the small intestine to he umbilicus. It's a true diverticulum arising from the antimesenteric border of the small bowel and often is associated with inflammatory bowel disease. Usually Meckel's diverticulum is asymptomatic; when it's complicated by bleeding, obstruction and inflammation, occurs as a symptomatic lesion but it's difficult to diagnose, because its signs and symptoms are identical to such common as Crhon's disease, appendicitis, and peptic ulcer diseases. The preoperative diagnosis of a Meckel's diverticulum, especially in the adult when asymptomatic, is still a serious problem; X-ray, US, radioisotopic scan and TAC are noninvasive, nonspecific test for the detection of this lesion. Many authors had suggested (to prevent its complications), the routine search during every laparotomy, with its surgical resection also in asymptomatic cases. The authors report their fifteen years experience in the diagnosis and treatment of 29 cases of patients with Meckel's diverticulum in the Susa Hospital (1976-1991).
Insights
Meckel
Area of Science:
- Gastroenterology and General Surgery
- Congenital Anomalies
- Surgical Pathology
Context:
- Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, affecting 1-3% of the population.
- It arises from the incomplete obliteration of the omphalomesenteric duct, a remnant of early fetal development.
- Often asymptomatic, it can present with complications like bleeding, obstruction, or inflammation, mimicking other common gastrointestinal conditions.
Purpose:
- To review the diagnosis and treatment of Meckel's diverticulum.
- To highlight the diagnostic challenges, particularly in asymptomatic adult cases.
- To discuss the implications of surgical intervention for preventing complications.
Summary:
- A retrospective analysis of 29 Meckel's diverticulum cases treated over 15 years (1976-1991) at Susa Hospital.
- The study details the diagnostic methods and surgical outcomes for both symptomatic and asymptomatic presentations.
- Non-invasive diagnostic tests (X-ray, US, radioisotopic scan, TAC) are noted as nonspecific for Meckel's diverticulum.
Impact:
- Emphasizes the difficulty in preoperative diagnosis of Meckel's diverticulum, especially in asymptomatic adults.
- Suggests routine surgical exploration and resection during laparotomy to prevent potential complications.
- Contributes to understanding the clinical management of this common congenital gastrointestinal anomaly.