Abstract

Aim: Giant Meckel diverticulitis is a rare developmental anomaly which usually presents with intestinal obstruction symptoms and is diagnosed during surgery. We present our cases to emphasize the clinical features of this anomaly.

Materials and Methods: Fourteen patients which were hospitalized an operated for various reasons and finally diagnosed as giant Meckel diverticulum between September 1997-September 2007 in our clinic were included. Nine male and 5 female patients, age ranging between 2 days-12 years, were evaluated retrospectively. Plain abdominal X-ray and abdominal ultrasonography were performed to all of the patients while two of them had also a computed tomography examination for diagnosis. In all cases, the diagnosis was made during surgery and the segment with Meckel diverticulum was resected and evaluated histopathologically.

Results: Three male patients (at 5, 8 and 10 month of age) and two female patients (at 3 and 7 month of age) presented with discomfort, vomiting, abdominal distension and rectal bleeding; Type I giant Meckel diverticulum was diagnosed during their operations. Two days old 4 patients (two male and two female) both who had abdominal cystic mass on antenatal ultrasound and presented with fecaloid vomiting, abdominal distension were immediately operated and the male patients were diagnosed as Type I, and the female patients as Type II giant Meckel diverticulum. At the operations of two male patients of 3 and 5 days and one female patient of 2 days of age, who were referred to our clinic with the suspicion of umbilical malformation and umbilical cord hernia on antenatal ultrasound, Type I giant Meckel diverticulum were diagnosed. Two other boys of ages 10 and 12, presented with acute abdominal findings; both were operated and were diagnosed as giant Meckel diverticulum and an associated volvulus was observed in both of the cases. When ileal segment of all patients where Meckel diverticulum is observed at, were examined diverticulum were determined. No complications were observed for patients on track.

Conclussion: Giant Meckel diverticulum doesn’t have typical findings, and though it is rare, it should always be considered in cases with intestinal obstruction and volvulus. Instead of risking the life of the patients with efforts and studies for diagnosis and thus losing the most valuable time, we believe that immediate operations would make the diagnosis definite, provide treatment of disease and save the life of the patient.