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梅克尔憩室的临床表现:八年经验

The clinical presentation of Meckel's diverticulum: Eight years experience.

作者信息

Jarboa Lutfi, Zarour Ahmad, Mustafa Sherif, Dawdi Salahaldeen, Suliman Idress, Gutti Tejeswe, Mansor Salah, Said Ghali Mohamed

机构信息

Acute Care Surgery Section, Hamad General Hospital, Doha, Qatar.

Department of Surgery, College of Medicine, Qatar University, Doha, Qatar.

出版信息

Turk J Surg. 2024 Dec 27;40(4):343-348. doi: 10.47717/turkjsurg.2024.6446. eCollection 2024 Dec.

Abstract

OBJECTIVES

Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract. It is commonly encountered during surgical practice as the cause of the patient's presentation or as an incidental finding during other unrelated procedures. This study aimed to evaluate the frequency of Meckel's diverticulum in our clinical practice and to provide an adequate level of knowledge of the clinical and diagnostic features and the management of Meckel's diverticulum.

MATERIAL AND METHODS

We analyzed the medical records of all cases who were diagnosed with Meckel's diverticulum at our hospital for over eight years. Age, sex, presentation, diagnostic procedures, surgical techniques, and histopathology were reviewed and analyzed.

RESULTS

A total of 104 patients were enrolled in our study. Mean age was 28.8 years, with male predominance in 92 (88.5%) patients. Symptomatic Meckel's diverticulum was detected in 80 (77%) patients and in 24 (23%) incidental findings. The most common emergency presentation was abdominal pain with 34 patients (42.5%), then intestinal obstruction with 20 patients (25%), bleeding per rectum with 12 patients (15%), acute abdomen with nine patients (11.3%), and intussusception with five patients (6.2%). Mean length of the Meckel's diverticulum was 4.3 centimeters. Small bowel resection was performed in 41 (45.1%) cases, stapled resection in 44 (48.3%), and ligated Meckel's base in 6 (6.4%). Ectopic gastric mucosa was the most common finding in histopathology in 30 (28.8%) patients.

CONCLUSION

Our study supports that the longer Meckel's diverticulum is, the more prone it is to developing complications, and stapler resection and small bowel resection are considered safe techniques, as well as resection of incidental Meckel's diverticulum, which does not increase the risk of morbidity.

摘要

目的

梅克尔憩室是胃肠道最常见的先天性异常。在外科手术中,它常作为患者临床表现的病因或在其他无关手术中偶然被发现。本研究旨在评估梅克尔憩室在我们临床实践中的发生率,并提供关于梅克尔憩室的临床和诊断特征及治疗的充分知识水平。

材料与方法

我们分析了我院八年来所有诊断为梅克尔憩室的病例的病历。对年龄、性别、临床表现、诊断方法、手术技术和组织病理学进行了回顾和分析。

结果

我们的研究共纳入104例患者。平均年龄为28.8岁,92例(88.5%)患者以男性为主。80例(77%)患者检测出有症状的梅克尔憩室,24例(23%)为偶然发现。最常见的急诊表现是腹痛,有34例患者(42.5%),其次是肠梗阻,有20例患者(25%),直肠出血12例患者(15%),急腹症9例患者(11.3%),肠套叠5例患者(6.2%)。梅克尔憩室的平均长度为4.3厘米。41例(45.1%)病例进行了小肠切除术,44例(48.3%)进行了吻合器切除术,6例(6.4%)结扎了梅克尔憩室基部。组织病理学中最常见的发现是异位胃黏膜,有30例患者(28.8%)。

结论

我们的研究支持梅克尔憩室越长,发生并发症的可能性越大,吻合器切除术和小肠切除术被认为是安全的技术,偶然发现的梅克尔憩室切除术也不会增加发病风险。

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本文引用的文献

1
Small bowel obstruction precipitated by intussusception of Meckel's diverticulum.梅克尔憩室肠套叠引发的小肠梗阻。
SAGE Open Med Case Rep. 2022 Jan 19;10:2050313X211072663. doi: 10.1177/2050313X211072663. eCollection 2022.
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Meckel's Diverticulum in Adults: Surgical Concerns.成人梅克尔憩室:手术相关问题
Front Surg. 2018 Sep 3;5:55. doi: 10.3389/fsurg.2018.00055. eCollection 2018.
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Meckel's diverticulum in the adult.成人的梅克尔憩室。
J Visc Surg. 2017 Sep;154(4):253-259. doi: 10.1016/j.jviscsurg.2017.06.006. Epub 2017 Jul 9.
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Meckel's Diverticulum: Factors Associated with Clinical Manifestations.梅克尔憩室:与临床表现相关的因素。
ISRN Gastroenterol. 2014 Apr 1;2014:390869. doi: 10.1155/2014/390869. eCollection 2014.
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Diverse presentations in pediatric Meckel's diverticulum: a review of 100 cases.小儿梅克尔憩室的多种表现:100例病例回顾
Pediatr Neonatol. 2014 Oct;55(5):369-75. doi: 10.1016/j.pedneo.2013.12.005. Epub 2014 Mar 28.

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