Ferranti F, Mondini O, Valle P, Castagnoli P
Divisione di Chirurgia Generale, Ospedale Civile di Bracciano, Roma.
G Chir. 1999 Mar;20(3):107-12.
Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract. The majority of MD cases are asymptomatic although they can, occasionally, cause complications such as bleeding, intestinal obstruction and/or inflammatory process. The diagnosis is difficult and it is usually made at surgery. The treatment of choice in the patients with symptomatic MD is surgical resection while difference of opinion there are about the treatment of asymptomatic MD. The present study concerns 9 cases of MD, 7 symptomatic and 2 incidentally found during surgical abdominal operations. Six patients was males and 3 females with 2:1 male: female ratio. The mean age was 14.7 years. The most common complication was the diverticulitis with the perforation of MD in 1 patient. All patients, symptomatic and asymptomatic, was operated. The diverticulectomy was made in 7 patients while in 2 cases we had to perform an intestinal resection. There was not operative mortality, while there were 2 cases of postoperative complications which occurred only in the patients with symptomatic MD. The Authors believe that there is no factor predictive of the development of diverticular complications. They recommend, in light of the low postoperative mortality and morbidity, the surgical treatment also in the cases of asymptomatic MD, in the absence of absolute contraindications.
梅克尔憩室(MD)是胃肠道最常见的先天性异常。大多数MD病例无症状,尽管偶尔会引发诸如出血、肠梗阻和/或炎症等并发症。诊断困难,通常在手术时才能确诊。有症状的MD患者的首选治疗方法是手术切除,而对于无症状MD的治疗则存在意见分歧。本研究涉及9例MD病例,7例有症状,2例在腹部手术中偶然发现。6例患者为男性,3例为女性,男女比例为2:1。平均年龄为14.7岁。最常见的并发症是憩室炎,1例患者出现MD穿孔。所有患者,无论有症状还是无症状,均接受了手术。7例患者进行了憩室切除术,2例患者不得不进行肠切除术。无手术死亡病例,有2例术后并发症,仅发生在有症状的MD患者中。作者认为不存在预测憩室并发症发生的因素。他们建议,鉴于术后死亡率和发病率较低,在无绝对禁忌证的情况下,无症状MD病例也应进行手术治疗。