Hamdi Louati, Riadh Jouini, Awatef Charieg, Ines Chouchen, Yosra Ben Ahmed, Faouzi Nouira, Said Jlidi
Objective: The aim of this study is to investigate the diagnosis and the treatment options of complicated Meckel’s diverticulum and compare that with the literature.
Material and Methods: This study retrospectively evaluated 51 patients who had been operated on for complicated Meckel’s diverticulitis in our department of Pediatric Surgery, between January 1999 and February 2016. Clinical symptoms, signs, radiologic data and therapeutic management were retrieved.
Results: A total of 51 children with a diagnosis of complicated Meckel’s diverticulitis (MD) were retrospectively analysed. The reason for consultation was an occlusive syndrome in 28 patients (55%), rectal bleeding or melena in 18 patients (35%) and isolated abdominal pain in 5 patients (10%). Abdominal ultrasound was performed in 49 patients, it was normal in 37% and it has objectified an intussusception in 26.5% of cases. All patients were operated. The way was a McBurney incision 45%, a midline laparotomy 21.5% and laparoscopic 33.5% of cases. The intra-operative diagnoses of MD complications were diverticulum perforation in 13.5%, mechanical intestinal obstruction due to diverticulum in 6%, diverticulum invagination in 21.5%, diverticulitis in 31.5%, volvulus in 3%, one attached to the hernia sac in Littre’s hernia and 21.5% appeared macroscopically healthy in intraoperative. All patients had partial small bowel resection and end-to-end anastomosis. Histopathologic ectopic tissue revealed: 21 gastric mucosa (41%), 3 pancreatic tissues (6%), 12 jejunal tissues (23.5%) and no heterotopic focus in 5 patients (10%).
Conclusion: Meckel’s diverticulitis does not have specific clinical and radiological findings. Surgical intervention is the only treatment and laparoscopy is increasingly used.