Abstract

Aim: The objective of this study is retrospective evaluation of treatment and follow-up of the cases of Meckel’s diverticulum (MD) diagnosed in our clinic.

Material and Method: Medical files of MD patients who were symptomatic or incidentally detected in Pediatric Surgery of Kanuni Sultan Süleyman Education and Research Hospital, Istanbul, Turkey, between 1987-2015, were retrospectively analyzed in terms of age, sex, clinical features, treatment modalities used, perioperative findings, complications, and histopathological types of surgery, histopathologic examination findings of the specimens and outcomes of the patients during follow-up period.

Results: One hundred and thirty-seven patients (107 males and 30 females; a M/F ratio of 3.5: 1.0) were enrolled in this study. The median age of the patients was 3.8 years. One hundred and ten patients (n=137) were symptomatic and underwent surgery, white 19% (n=27) of them were diagnosed incidentally, and were follow-up without surgery. Presenting symptoms, in order of frequency, were diverticulitis (n=31, 28%), intestinal obstruction (n=19, 16%), gastrointestinal bleeding (n=30, 27%), intussusception (n=22, 20%), and volvulus (n=3). Twenty-seven of the cases were incidentally discovered during surgical interventions for umbilical cord prolapsus, gastroshisis, duodenal atresia, diaphragmatic hernia and strangulated inguinal hernia. Forty-five patients underwent partial small bowel resection and anastomosis. A further 65 patients underwent wedge resection. During histopathological examinations mostly mucosal congestion, edema, bleeding, and ischemic changes were reported. Ectopic gastric mucosa was detected in 24 (22%) of the patients and focal heterotopic pancreatic tissue was identified in 1 patient. During postoperative period, 2 patients had to be reoperated because of intestinal adhesions. Three patients who underwent surgery died due to multiple organ failure secondary to diffuse/delayed peritonitis, Two patients who were incidentally detected became symptomatic cases. One of these patients with rectal bleeding, and the other one with intussusception were operated.

Conclusion: In symptomatic cases, frequently acute abdomen is the predominant finding, and delay in diagnosis can lead to fatal complications. In patients who present with challenges in diagnosis, complications of MD should be kept in mind.