Ovrebø K K, Haram S, Vaage S
Kirurgisk avdeling, Sentralsjukehuset i Sogn og Fjordane, Førde.
Tidsskr Nor Laegeforen. 1991 Apr 30;111(11):1361-3.
Meckel's diverticulum is a rare, but serious cause of acute abdominal pain. The prevalence of Meckel's diverticulum is 2% and lifetime risk of illness in a diverticulum is 4.2%. The risk declines with age and approaches zero after the age of 70. Morbidity after resection of symptomatic Meckel's diverticulum is 11.1-17.6% with 6.0-7.5% mortality. The morbidity rate for resection of incidentally discovered diverticulum is 1.2-8.9%. Symptoms and complications are related to age. Below the age of one year the most prevalent complication is gastrointestinal obstruction. Later in childhood the most dominating complication is peptic ulcer with serious gastrointestinal bleeding, while various kinds of gastrointestinal obstruction and diverticulitis are most prevalent in adults. The treatment of symptomatic Meckel's diverticulum is resection. However, the treatment of incidentally discovered Meckel's diverticulum is a subject of dispute. After a thorough study of the literature we conclude that resection should be the routine for all incidentally discovered Meckel's diverticulums in persons younger than 40. After this age resection should be reserved for patients with palpable stigmata of heterotopic tissue, diverticulums of some length and the presence of omphaloenteric- or omphalodiverticulare chords.
梅克尔憩室是引起急性腹痛的一种罕见但严重的病因。梅克尔憩室的患病率为2%，憩室患者一生患病风险为4.2%。该风险随年龄增长而降低，70岁后接近零。有症状的梅克尔憩室切除术后的发病率为11.1 - 17.6%，死亡率为6.0 - 7.5%。偶然发现的憩室切除术后的发病率为1.2 - 8.9%。症状和并发症与年龄有关。1岁以下最常见的并发症是胃肠道梗阻。儿童期后期最主要的并发症是伴有严重胃肠道出血的消化性溃疡，而各种胃肠道梗阻和憩室炎在成年人中最为常见。有症状的梅克尔憩室的治疗方法是切除。然而，偶然发现的梅克尔憩室的治疗存在争议。在对文献进行全面研究后，我们得出结论，对于40岁以下偶然发现的所有梅克尔憩室，切除应作为常规治疗方法。40岁以后，切除应仅用于有可触及的异位组织体征、一定长度的憩室以及存在脐肠或脐憩室索带的患者。
