Hansen Carl-Christian, Søreide Kjetil
Medical Faculty, University of Bergen, Bergen Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Medicine (Baltimore). 2018 Aug;97(35):e12154. doi: 10.1097/MD.0000000000012154.
The contemporary demographics and prevalence of Meckel's diverticulum, clinical presentation and management is not well described. Thus, this article aims to review the recent literature concerning Meckel's diverticulum.
A systematic PubMed/Medline database search using the terms "Meckel" and "Meckel's" combined with "diverticulum." English language articles published from January 1, 2000 to July 31, 2017 were considered. Studies reporting on the epidemiology of Meckel's diverticulum were included.
Of 857 articles meeting the initial search criteria, 92 articles were selected. Only 4 studies were prospective. The prevalence is reported between 0.3% and 2.9% in the general population. Meckels' diverticulum is located 7 to 200 cm proximal to the ileocecal valve (mean 52.4 cm), it is 0.4 to 11.0 cm long (mean 3.05 cm), 0.3 to 7.0 cm in diameter (mean 1.58 cm), and presents with symptoms in 4% to 9% of patients. The male-to-female (M:F 1.5-4:1) gender distribution is reported up to 4 times more frequent in men. Symptomatic patients are usually young. Of the pediatric symptomatic patients, 46.7% have obstruction, 25.3% have hemorrhage, and 19.5% have inflammation as presenting symptom. Corresponding values for adults are 35.6%, 27.3%, and 29.4%. Ectopic gastric tissue is present in 24.2% to 71.0% of symptomatic Meckel's diverticulum, is associated with hemorrhage and is the most common form of ectopic tissue, followed by ectopic pancreatic tissue present in 0% to 12.0%.
The epidemiological patterns and clinical presentation appears stable in the 21st century. A symptomatic Meckel's diverticulum is managed by resection. The issue of prophylactic in incidental Meckel's diverticulum resection remains controversial.
目前关于梅克尔憩室的人口统计学特征、患病率、临床表现及治疗方法尚无详尽描述。因此，本文旨在回顾近期有关梅克尔憩室的文献。
在PubMed/Medline数据库中进行系统检索，检索词为“梅克尔”（Meckel）和“梅克尔氏”（Meckel's）并结合“憩室”（diverticulum）。纳入2000年1月1日至2017年7月31日发表的英文文章。纳入报道梅克尔憩室流行病学的研究。
在857篇符合初步检索标准的文章中，筛选出92篇。仅有4项研究为前瞻性研究。一般人群中患病率报道为0.3%至2.9%。梅克尔憩室位于回盲瓣近端7至200厘米处（平均52.4厘米），长0.4至11.0厘米（平均3.05厘米），直径0.3至7.0厘米（平均1.58厘米），4%至9%的患者有症状表现。男性与女性的性别分布比例（男:女为1.5 - 4:1）显示男性发病频率高达女性四倍。有症状的患者通常较为年轻。儿科有症状患者中，46.7%以肠梗阻为首发症状，25.3%以出血为首发症状，19.5%以炎症为首发症状。成人相应比例分别为35.6%、27.3%和29.4%。有症状的梅克尔憩室中，24.2%至71.0%存在异位胃组织，与出血相关，是最常见的异位组织形式，其次是异位胰腺组织，占0%至12.0%。
21世纪梅克尔憩室的流行病学模式和临床表现似乎较为稳定。有症状的梅克尔憩室通过手术切除治疗。偶然发现的梅克尔憩室是否进行预防性切除仍存在争议。
