Abstract

BARRERA LOZANO, Luis Manuel; VELEZ ROMAN, Juan Carlos; LONDONO SCHIMMER, Eduardo Emilio  and  LOPEZ PANQUEVA, Rocío del Pilar. Divertículo de Meckel en el paciente adulto: “Experiencia en la Fundación Santa Fe de Bogotá”. Rev Col Gastroenterol [online]. 2005, vol.20, n.3, pp.11-17. ISSN 0120-9957.

OBJECTIVE: Review the clinical presentation, diagnosis and treatment of adult patients with a diagnosis of Meckel`s diverticulum treated at the Fundación Santa Fe de Bogotá University Hospital between 1991 and 2003. MATERIALS AND METHODS: This is a descriptive case series study. A review of the 13 clinical charts of the patients with a diagnosis of Meckel´s diverticulum was performed, searching for information related to clinical presentation, transoperative findings, surgical procedure performed and final pathology report. RESULTS: Thirteen cases were identified. The majority of our patients were males (69.2%) with an average age of 40.4 years. Eight patients (61.5%) complained of digestive symptoms but in only six of them, symptoms were due to a complication of the Meckel´s diverticulum. Obstruction was the most common complication, 3 patients (50%), lower gastrointestinal bleeding in two and diverticulitis in one. An intestinal resection including the diverticulum and primary end-to-end anastomosis was performed in 53% of the cases. Ectopic gastric mucosa was found in four of our 13 patients (30.7%). CONCLUSION: Although infrequent, the existence of a Meckel´s diverticulum should always be considered in the differential diagnosis of patients with abdominal symptoms, and presenting with lower gastrointestinal tract bleeding. In cases of Meckel`s diverticulitis, abdominal pain can mimic acute appendicitis. Differential diagnosis includes intestinal obstruction of a different aetiology (such as adhesions, gallstone ileus) and acute colonic diverticulis. In cases of lower gastrointestinal tract bleeding the presence of Meckel`s diverticulum should be considered. A complete work-up is extensively justified when other causes of bleeding have been ruled out. Although our series is very small our findings were similar to those reported in the literature.

Keywords : Meckel`s Diverticulum; adult; abdominal pain; gastrointestinal bleeding; intestinal obstruction.

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