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Complicated Meckel's diverticulum: Presentation modes in adults
Complicated Meckel's diverticulum represents a common etiology of acute abdomen in children. However, this condition is less frequent in adults. We reviewed the records of adult patients who underwent the surgical removal of complicated Meckel's diverticulum between 2001 and 2017 at 2 tert...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6160168/ https://www.ncbi.nlm.nih.gov/pubmed/30235734 http://dx.doi.org/10.1097/MD.0000000000012457 |
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author | Parvanescu, Alina Bruzzi, Matthieu Voron, Thibault Tilly, Camille Zinzindohoué, Franck Chevallier, Jean-Marc Gucci, Marco Wind, Philippe Berger, Anne Douard, Richard |
author_facet | Parvanescu, Alina Bruzzi, Matthieu Voron, Thibault Tilly, Camille Zinzindohoué, Franck Chevallier, Jean-Marc Gucci, Marco Wind, Philippe Berger, Anne Douard, Richard |
author_sort | Parvanescu, Alina |
collection | PubMed |
description | Complicated Meckel's diverticulum represents a common etiology of acute abdomen in children. However, this condition is less frequent in adults. We reviewed the records of adult patients who underwent the surgical removal of complicated Meckel's diverticulum between 2001 and 2017 at 2 tertiary French medical centers. We then analyzed the clinical characteristics, mode of presentation, and management for all patients. The Meckel's diverticulum was resected in 37 patients (24 males and 13 females). The mean patient age was 46.1 ± 21.4 years. The most common clinical presentations of complicated Meckel's diverticulum were diverticulitis (35.1%, n = 13), small-bowel obstruction (35.1%, n = 13), and gastrointestinal bleeding (29.8%, n = 11) (anemia, n = 1; hematochezia, n = 10). Age distribution was significantly different (P = .02) according to the 3 Meckel's diverticulum complications: patients with diverticulitis (P = .02) were statistically more frequently over 40 (P = .05), significantly older than patients with gastrointestinal bleeding who were more frequently <40 (P = .05). There was a preoperative diagnosis available for 15 of the 37 patients (40%). An exploratory laparoscopy was necessary to determine the cause of disease for the other 22 patients (60%). An intestinal resection was performed in 33 patients (89%) and diverticulectomy was performed in 4 patients (11%). There was heterotopic tissue found in only 6 patients (16%). Postoperative complications were as follows: 1 death by cardiac failure in a 92-year-old patient and 2 patients with postoperative wound infections. The follow-up time was 3 to 12 months. The correct diagnosis of complicated Meckel's diverticulum in adults is difficult due to the lack of specific clinical presentation. As a result, exploratory laparoscopy appears to play a central role in cases of acute abdomen with uncertain diagnosis. |
format | Online Article Text |
id | pubmed-6160168 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-61601682018-10-12 Complicated Meckel's diverticulum: Presentation modes in adults Parvanescu, Alina Bruzzi, Matthieu Voron, Thibault Tilly, Camille Zinzindohoué, Franck Chevallier, Jean-Marc Gucci, Marco Wind, Philippe Berger, Anne Douard, Richard Medicine (Baltimore) Research Article Complicated Meckel's diverticulum represents a common etiology of acute abdomen in children. However, this condition is less frequent in adults. We reviewed the records of adult patients who underwent the surgical removal of complicated Meckel's diverticulum between 2001 and 2017 at 2 tertiary French medical centers. We then analyzed the clinical characteristics, mode of presentation, and management for all patients. The Meckel's diverticulum was resected in 37 patients (24 males and 13 females). The mean patient age was 46.1 ± 21.4 years. The most common clinical presentations of complicated Meckel's diverticulum were diverticulitis (35.1%, n = 13), small-bowel obstruction (35.1%, n = 13), and gastrointestinal bleeding (29.8%, n = 11) (anemia, n = 1; hematochezia, n = 10). Age distribution was significantly different (P = .02) according to the 3 Meckel's diverticulum complications: patients with diverticulitis (P = .02) were statistically more frequently over 40 (P = .05), significantly older than patients with gastrointestinal bleeding who were more frequently <40 (P = .05). There was a preoperative diagnosis available for 15 of the 37 patients (40%). An exploratory laparoscopy was necessary to determine the cause of disease for the other 22 patients (60%). An intestinal resection was performed in 33 patients (89%) and diverticulectomy was performed in 4 patients (11%). There was heterotopic tissue found in only 6 patients (16%). Postoperative complications were as follows: 1 death by cardiac failure in a 92-year-old patient and 2 patients with postoperative wound infections. The follow-up time was 3 to 12 months. The correct diagnosis of complicated Meckel's diverticulum in adults is difficult due to the lack of specific clinical presentation. As a result, exploratory laparoscopy appears to play a central role in cases of acute abdomen with uncertain diagnosis. Wolters Kluwer Health 2018-09-21 /pmc/articles/PMC6160168/ /pubmed/30235734 http://dx.doi.org/10.1097/MD.0000000000012457 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 |
spellingShingle | Research Article Parvanescu, Alina Bruzzi, Matthieu Voron, Thibault Tilly, Camille Zinzindohoué, Franck Chevallier, Jean-Marc Gucci, Marco Wind, Philippe Berger, Anne Douard, Richard Complicated Meckel's diverticulum: Presentation modes in adults |
title | Complicated Meckel's diverticulum: Presentation modes in adults |
title_full | Complicated Meckel's diverticulum: Presentation modes in adults |
title_fullStr | Complicated Meckel's diverticulum: Presentation modes in adults |
title_full_unstemmed | Complicated Meckel's diverticulum: Presentation modes in adults |
title_short | Complicated Meckel's diverticulum: Presentation modes in adults |
title_sort | complicated meckel's diverticulum: presentation modes in adults |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6160168/ https://www.ncbi.nlm.nih.gov/pubmed/30235734 http://dx.doi.org/10.1097/MD.0000000000012457 |
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