Meckel’s diverticulum : a clinical approach in Mosul province

Abstract EN

Objective: To study the presentations of Meckel’s diverticulum (MD), and to highlight the possible sources of complications and point out the management and frequency of this congenital anomaly in our study.

Methods: A prospective randomized study over a period of 10 years, a total of sixty eight patients with MD were studied in a series of 2826 patients who underwent laparotomies for various reasons both urgent and elective with different presentations, managed by one consultant surgeon.

All cases proved to have MD at surgery, resected and send for histopathological studies, and all being studied for evidence of complications possible post operative outcomes and followed up for at least 2 years.

Results: Of 2826 patients included in this study, 68 patients (2.4%) were found to have MD, male to female ratio was 1.72:1.

The diverticula’s were incidental in 47.1%, and they underwent excisions in addition to the treatments of their a primary abdominal pathologies.

Symptomatic MD seen in 52.9%, mostly in form of diverticulitis and intestinal obstruction 41.7% , 38.9% respectively, rarely intussusceptions and bleeding 8.3% for each, and very rarely as carcinoid tumor, 2.8%.

In 15 patients out of 36 of symptomatic MD mimic acute appendicitis, co-excistence of both diverticulitis and appendicitis seen in 3 of them.

Anatomical features of MD variables, 82.% less than 6 cm in length, 76.5% with wide based mouth, and 88.% located within 50 cm from ileocaecal junction, and 75% were with ileal mucoca.

Conclusions: Complicated MD might mimic any acute abdominal disorders, majority were appendicitis, we advocate to search for MD in laparotomised patients and to be resected once they were found, also we recommend in light of absence of mortality and morbidity, to resect the asymptomatic MD synchronously together with treatment of primary pathology in absence of absolute contraindications.