Management of symptomatic Meckel's diverticulum

ABSTRACT

The objective of this study was to evaluate the management of symptomatic Meckel's diverticulum. This study was conducted between November, 1999 to November, 2001 at three surgical and one pediatric surgical unit in Sandeman [Prov] Hospital Quetta.A total of 1995 patients were operated with provisional diagnosis of acute abdomen out of which 20 cases were of Meckel's diverticulum. In most of the patients resection of Meckel's diverticulum or resection of gut with Meckel's diverticulum was done and anastomosis performed. The mean age was 16.05 years with male female ratio 91. Abdominal pain was the most common symptom [75%]. Operative findings were volvulus around a band between Meckel's diverticulm and umbilicus in four [20%], omphalodiverticular fibrous band causing kinking of the adjacent gut in two [10%], ileocolic intussusception due to Meckel's diverticulum in two [10%], volvulus around a band with gangrene of gut in two [10%], mesodiverticular band entrapping a small bowel loop in one [5%], inflamed perforated Meckel's diverticulum causing peritonitis and intestinal obstruction in one each [5%], inflamed thick edematous Meckel's diverticulum in six [30%], patent vitellointestinal duct with Meckel's diverticulum in one [5%] and bleeding Meckel's diverticulum in one [5%]. The patients who presented with acute abdomen, no preoperative diagnosis regarding involvement of diseased Meckel's diverticulum can be reached with most of the available modalities of investigation in this region. In children presenting with acute abdomen Meckel's diverticulum must be kept in mind