Surprise in the operating room: Meckel’s diverticulum complications

Öz

Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, with an incidence of approximately 2%. While the majority of cases remain asymptomatic, significant clinical complications such as gastrointestinal bleeding, intestinal obstruction, perforation, and inflammation may develop in some cases. In this study, three different complications of Meckel's diverticulum that eluded preoperative diagnosis are presented: diverticular bleeding detected only during intraoperative colonoscopy in a 24-year-old male patient; intestinal ischemia due to mesodiverticular band in a 26-year-old male patient; and adhesive small bowel obstruction and ischemia resulting from diverticulitis in a 50-year-old male patient. This case report highlights the diagnostic difficulties and surgical management strategies of Meckel's diverticulum complications while also demonstrating the clinical importance of considering this entity in the differential diagnosis of patients presenting with unexplained abdominal pain. Given the diagnostic limitations of current imaging modalities, surgical exploration in suspected cases has both diagnostic and therapeutic value.

Anahtar Kelimeler

• Meckel’s diverticulum
• Intestinal obstruction
• Gastrointestinal hemorrhage
• Diverticulitis
• Ischemia

Ameliyathane odasında karşılaşılan sürpriz: Meckel divertikül komplikasyonları

Öz

Meckel divertikülü, gastrointestinal sistemin en sık görülen konjenital anomalisidir ve insidansı yaklaşık %2'dir. Vakaların çoğu asemptomatik kalmakla birlikte, bazı vakalarda gastrointestinal kanama, intestinal obstrüksiyon, perforasyon ve inflamasyon gibi önemli klinik komplikasyonlar gelişebilir. Bu çalışmada, ameliyat öncesi tanıda gözden kaçan Meckel divertikülünün üç farklı komplikasyonu sunulmaktadır: 24 yaşındaki erkek hastada sadece intraoperatif kolonoskopi sırasında tespit edilen divertiküler kanama, 26 yaşındaki erkek hastada mezodivertiküler bant nedeniyle oluşan bağırsak iskemisi ve 50 yaşındaki erkek hastada divertikülit nedeniyle oluşan yapışkan ince bağırsak tıkanıklığı ve iskemi. Bu vaka raporu, Meckel divertikülünün komplikasyonlarının tanı zorluklarını ve cerrahi tedavi stratejilerini vurgulamakta ve aynı zamanda açıklanamayan karın ağrısı ile başvuran hastaların ayırıcı tanısında bu durumun dikkate alınmasının klinik önemini göstermektedir. Mevcut görüntüleme yöntemlerinin tanı sınırlamaları göz önüne alındığında, şüpheli vakalarda cerrahi inceleme hem tanısal hem de terapötik değere sahiptir.

Anahtar Kelimeler

• Meckel divertikülü
• Bağırsak tıkanıklığı
• Gastrointestinal kanama
• Divertikülit
• İskemi

Kaynakça

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