COMPLICATIONS OF THE MECKEL’S DIVERTICULUM, about 42 cases.

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Vol. 87 No. 4 (2009): Issue Apr 2009

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Mohamed Issam Beyrouti
Mohamed Ben Amar
Ramez Beyrouti
Mohamed Abid
Lobna Ayadi
Laboratoire d'Anatomie et de CytologiePathologiques CHU. Habib Bourguiba Sfax-Tunisie
Oussama Abid
Rached Derbel
Najla Feriani
Mohamed Azzaza
Mohamed Béchir Khalifa
Salah Boujelben
Ali Ghorbel

Abstract

Aim : Our aim was to report the main complications of the Meckel’s diverticulum.
Methods: Our retrospective study concerns 42 cases of complicated Meckel’s diverticulum, collected during one period of 18 active years from january 1988 to december 2005. The yearly impact is 2,33 cases / year. We excluded the asymptomatic Meckel’s diverticulum, of fortuitous discovery during intervention.
Results: The middle age of our patients is 25 years, with extremes going from 2 to 74 years. The sex-ratio is 3,2. The diagnosis before intervention of the complicated Meckel’s diverticulum was not evoked in any time. The clinical features were an acute intestinal closure in 22 cases, an appendicitis in 13 cases, an appendicular peritonitis in 6 cases, and an acute intestinal intussusceptions in one case. In any case, it is the surgical exploration that permitted to confirm the diagnosis of a complicated Meckel’s diverticulum. The approach way was median in 27 cases, Mac Burney in 13 cases, and laparoscopic in 2 cases. The surgical exploration showed peritonitis in 16 cases, one diverticulitis in 23 cases, an acute intestinal intussusception in one case, a tumour in one case, and haemorrhagic diverticulum’s ulcer in one case. The treatment consisted in a segmental resection of ileum with end to end anastomosis (37 cases) and a cuneiform resection (5 cases). The histological exam showed heterotopy of gastric tissue in 12 cases, of pancreatic tissue in two cases, and a Burkitt’s lymphoma on a diverticulum in one case. We noted a precocious death following a septic shock.
Conclusion: The Meckel’s diverticulum constitutes a most common benign malformation of the digestive tube. The prognosis is related extensively to the gravity of its complications that can benefit, not only of the contribution of the laparoscopic diagnosis, but also therapeutic.

Keywords:

Complications of the Meckel's diverticulum, diverticulites, heterotopy, laparoscopiy

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