Demartines N, Herzog U, Tondelli P, Harder F
Chirurgische Abteilung, St. Claraspital Basel.
Helv Chir Acta. 1992 Aug;59(2):325-9.
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.
本文报告了对巴塞尔州立医院和圣克拉拉医院所有患有梅克尔憩室（MD）的患者进行的为期20年（1971 - 1990年）的回顾性随访。共有57名男性和34名女性，平均年龄46.7岁（14 - 89岁）。60.4%的病例为偶然发现，39.6%为有症状的MD。在同一时期进行了5000例阑尾切除术（憩室切除术与阑尾切除术的比例为1:50）。38.5%的MD切除术是在怀疑为急性阑尾炎时进行的。在三分之一的病例中，MD是症状的原因。组织学检查结果为13%非特异性炎症、10%穿孔、9.8%异位组织、6.5%出血和4.3%肿瘤。36例有病理检查结果的患者中有8例出现术后并发症（21.6%），死亡率为8.1%。在55%切除的MD中，无任何其他组织学检查结果，仅发现1例并发症（术后肠梗阻）（1.9%）；死亡率为零。对这些数据的分析表明，MD的并发症不仅出现在年轻患者中。MD合并额外异位的患者更容易出现并发症。我们建议对偶然发现的梅克尔憩室进行切除。
