Meckel's diverticulum : retrospective analysis of 24 cases on the surgical ward of Bjelovar general hospital inthe period from 1980-2004

In this paper the authors analyze 24 cases of Meckel's diverticulum which were operated on in a 25 year period in Bjelovar (1980 – 2004). The aim of the paper is to compare our findings with retrospective analyses found in national and international literature.
Surgery was performed on 24 patients with Meckels diverticulum, in which 22 (92%) were diagnosed as the primary finding, and in 2 cases (8%) the diagnosis was made during laparotomy. 19 (80%) patients with complications of Meckels diverticulum were children, 3(12%) of them in early adolescence, 2 (8%) aged between 40 and 50 years. 18 patients (75%) were male and 6 (25%) female. The youngest child was 14 months old and the oldest 13.5 years (mean 9.7 years). 15 children (79%) were male and 4 (21%) female. In most cases we confirmed the diagnosis with explorative laparotomy, and in some cases we combined X ray of the abdomen, UZV, technetium 99m pertechnetate scintigraphy, CT of the abdomen. In 17 (71%) cases the reason for performing the operation was the clinical picture that showed all the signs of acute appendicitis. In 18 (75%) cases we performed diverticulectomy, bowl resection with diverticulectomy in 5 (21%) cases, and in one case we performed laparoscopic diverticulectomy. Patho-histological findings in 19 (79%) cases of Meckel's divericulum showed normal intestinal mucosa, ectopical mucosa of the stomach in 3 (13%) cases, and in 2 cases the patho-histological findings were unclear. The authors describe that preoperational diagnosis of Meckel diverticulum is rare and very difficult to determine. In spite of great progress in medical technology there is still today no efficient and reliable diagnostic procedure for Meckel divericul. Multiple diagnostical procedures should be included in finding the final diagnosis of Meckel diverticulum prior to surgery. The criteria that should be taken into consideration are male gender, age less than 40 years, the nature of the operation and the reason why laparotomy has been performed, the size and the location of the diverticula, a short base and if there is a palplatore ectopic mucosa. Laparoscopy should be performed not only as a therapeutic measure but as a diagnostic one as well, and resection should be made using endoscopy with or without a mini laparotomy.
Category: Clinical observations - professional paper
Volume: Vol. 50, No 3, july - september 2006
Authors: D. Košćak, B. Župančić, J. Lovrić, D. Koprek, K. Košćak
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