Semptomatik Meckel Divertikülleri ve Tecrübelerimiz

Amaç: Meckel divertikülü (MD) Gastrointestinal sistemin en sık anomalisidir (%2). Bu çalışma ile MD’li hastalarımızın yaş, cinsiyet, tanı, cerrahi patoloji ve ektopik dokuları hakkındaki tecrübelerimizi retrospektif olarak değerlendirmek istedik. Yöntem: 2007–2012 yılları arasında 4 farklı merkezde karın ağrısı nedeni ile ameliyat edilen 1931 vaka retrospektif olarak değerlendirildi. Bu komplikasyonlarıydı. Tüm hastalara ameliyat öncesi laboratuvar ve karın

Anahtar Kelimeler:

Meckel Divertikülü, Çocuk, Tanı

-

Objective: Meckel’s diverticulum (MD) is the most common congenital malformation of the gastrointestinal tract (%2). We want to present our experience about age, gender, diagnosis, surgical pathology and ectopic tissue of Meckel’s diverticulum by this retrospective study. Method: Between 2007 and 2012, 1931 patients with abdomen pain were operated at the department of four different pediatric surgery. The cause of abdominal pains was complications of MD in 18 patients. In patients, preoperative laboratory and imaging were performed. Surgical management was made in all patients and specimens were sent for histopathologic examination. Results: Meckel's pathology has an incidence of approximately 0.9% in our patients with laparotomy. There were 16 (88.9%) male and two (11.1%) girl. There was rectal bleeding in eight (44.4%) patients, intestinal obstruction in two (11.1 %) patients, diverticulitis in five (27.7%) patients. Two patients (11.1 %) presented umbilical fistula that it was fixated in umbilical cord hernia. One patient (5.5%) presented with umbilical abscess. At surgery, a wedge resection was carried out in eight cases and a segmental resection was carried out in 10. Histopathology revealed ectopic gastric mucosa in 8 patients (44.4%). Conclusion: Although Meckel’s diverticulum is the most common congenital malformation of the small intestine, Meckel’s diverticulum is rarely symptomatic. The clinical presentations of MD can be variety. Preoperative diagnosis rate is low. For this reason, the surgeon should pay attention to Meckel's pathologies during laparotomy

Keywords:

Meckel Diverticulum, Child, Diagnosis,

PDF

___

Tseng YY, Yang YJ. Clinical and diagnostic relevance of Meckel's diverticulum in children. Eur J Pediatr 2009;168(12):1519-23.
Menezes M, Tareen F, Saeed A, et al. Symptomatic Meckel's diverticulum in children: a 16-year review. Pediatr Surg Int 2008;24(5):575-7.
Sayan A, Arıkan A, Okay ST, ve ark. Çocuklarda dev Meckel divertikülleri. Çocuk Cerrahisi Dergisi 2008;22(3):127-32.
Durakbasa CU, Okur H, Mutus HM, et al. Symptomatic omphalomesenteric duct remnants in children. Pediatr Int 2010;52(3):480-4.
Méndez-García C, Suárez-Grau JM, Rubio-Chaves C, et al. Surgical pathology associated with Meckel´s diverticulum in a tertiary hospital: 12 year review. Rev Esp Enferm Dig 2011;103(5):250-4.
Blevrakis E, Partalis N, Seremeti C, et al. Meckel's diverticulum in paediatric practice on Crete (Greece): a 10-year review. Afr J Paediatr Surg 2011;8(3):279-82.
Bilici S, Melek M, Göksu M, ve ark. Çocuklarda Nadir Bir Akut Batın Nedeni: Meckel Divertikülünün Aksiyal Torsiyonu ve Fibröz Banda Bağlı İnternal Herni. Van Tıp Dergisi 2011;18(4):205-7.
Park JJ, Wolff BG, Tollefson MK, et al. Meckel diverticulum: the Mayo Clinic experience with 1476 patients (1950-2002). Ann Surg 2005;241(3):529-33.
Ruscher KA, Fisher JN, Hughes CD, et al. National trends in the surgical management of Meckel's diverticulum. J Pediatr Surg 2011;46(5):893-6.
Malik AA, Wani KA, Khaja AR. Meckel's diverticulum-Revisited. Saudi J Gastroenterol 2010;16(1):3-7.
Korkmaz Ö, Yılmaz HG, Keleş C. Erişkinlerde Görülen Meckel Divertikül Komplikasyonları. Turkiye Klinikleri J Med Sci. 2007;27(4):518-21.
Yachouchyy EK, Marano AF, Etienne JCF, et al. Meckel’s diverticulum. J Am Coll Surg 2001;192(5):658– 62.
Snyder CL. Current management of umbilical abnormalities and related anomalies. Semin. Pediatr. Surg 2007;16(1):41–9.
Nose S, Okuyama H, Sasaki T, et al. Torsion of Meckel's Diverticulum in a Child. Case Rep Gastroenterol 2013;7(1):14-8.
Asabe K, Oka Y, Kai H, et al. Iatrogenic ileal perforation: an accidental clamping of a hernia into the umbilical cord and a review of the published work. J Obstet Gynaecol Res 2008;34(4):619-22.
Mackey WC, Dineen P. A fifty year experience with Meckel's diverticulum. Surg gynecol obstet 1983;156(1):56-64.

ISSN: 1309-3878
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez