Charki Mohammed Tazi, Oukhouya Mohammed-Amine, Benmassaoud Zineb, Mahmoudi Abdelhalim, Khattala Khalid, Bouabdallah Youssef
Centre Hospitalier Universitaire Hassan II, Université Sidi Mohamed Ben Abdellah, Département de Chirurgie Pédiatrique, Fès, Maroc.
Pan Afr Med J. 2019 Jun 14;33:113. doi: 10.11604/pamj.2019.33.113.18756. eCollection 2019.
Meckel's diverticulum (MD) is a remnant of omphalomesenteric channel. It is often asymptomatic but it can be responsible for various clinical complications and variable clinical status especially in children. We conducted a retrospective study on complications of MD among children hospitalized in the division of Paediatric Surgery at the University Hospital Hassan II, Fez, Morocco. The study aimed to describe the clinical, radiological and therapeutic features of MD. The study was conducted over a period of 10 years (January 2009 - December 2018) and involved 18 children (15 boys and 3 girls) aged 1 day - 15 years (with an average age of 5 years) who had undergone surgery for complications of MD. Acute intussusception and intestinal occlusion were the most frequent complications. Other complications included: infection of the MD (1 case) and digestive hemorrhage (2 cases). Two rare types of neonatal Meckel's diverticulum were described (neonatal occlusion and fistula associated with omphalocele). In no case, abdominal X-ray without treatment, ultrasound and CT scan showed MD. Scintigraphy was performed in 2 patients with hematochezia and it helped to make the diagnosis of MD in one case. Three patients underwent laparoscopic surgery with resection of the MD and intestinal anastomosis with laparoscopy. The other patients underwent laparotomy. Ileostomy was performed in one case, followed by secondary recovery. Patient's outcome was good, except for one case of anastomotic leakage. Anatomopathological examination showed two cases of heterotopia.
梅克尔憩室(MD)是卵黄管的遗迹。它通常无症状,但可导致各种临床并发症和不同的临床状况,尤其是在儿童中。我们对摩洛哥非斯哈桑二世大学医院儿科手术科住院的儿童MD并发症进行了一项回顾性研究。该研究旨在描述MD的临床、放射学和治疗特征。研究为期10年(2009年1月至2018年12月),纳入了18名年龄在1天至15岁(平均年龄5岁)因MD并发症接受手术的儿童(15名男孩和3名女孩)。急性肠套叠和肠梗阻是最常见的并发症。其他并发症包括:MD感染(1例)和消化道出血(2例)。描述了两种罕见的新生儿梅克尔憩室类型(新生儿梗阻和与脐膨出相关的瘘管)。在任何情况下,未经治疗的腹部X线、超声和CT扫描均未显示MD。2例便血患者进行了闪烁扫描,其中1例有助于诊断MD。3例患者接受了腹腔镜手术,切除MD并进行腹腔镜肠吻合术。其他患者接受了剖腹手术。1例患者进行了回肠造口术,随后二期恢复。除1例吻合口漏外,患者预后良好。解剖病理学检查显示2例异位。