Erişkin hastalarda semptomatik Meckel Divertikülü: Tek merkez 6 yıllık klinik deneyim ve sonuçlarımız

Öz

Amaç: Meckel divertikülü (MD), doğum sonrasında omfalomezenterik veya vitellin kanalın tam olmayan obliterasyonu sonucunda oluşan embriyolojik bir kalıntıdır ve gastrointestinal sistemin en sık gözlenen konjenital anomalisidir. MD genellikle asemptomatik olup; genellikle çocuk hasta popülasyonunda semptom vermektedir. Bu çalışmada; akut batının ayırıcı tanısında önemli yeri olan, preoperatif dönemde tanı konulmasının zor olduğu MD’nin güncel literatür bilgileri eşliğinde klinikopatolojik özelliklerinin analizi ve sonuçların incelenmesi amaçlandı. Gereç ve Yöntemler: Ocak 2017 - Ocak 2023 tarihleri arasında genel cerrahi kliniğinde Meckel divertikülü tanısı alan ve ameliyat edilen hastalar retrospektif olarak tarandı. Çalışmaya 18 yaşın altındaki hastalar ve inflamatuar bağırsak hastalığı tanısı olan hastalar dahil edilmedi. Hastaların preoperatif, intraoperatif ve postoperatif verileri incelenerek analiz edildi. Bulgular: Çalışmaya dahil edilen 22 olgunun yaş ortalaması 44,6 ± 14,6 yaş (20-74 yaş) idi. 16 olgu erkek, 6 olgu ise kadındı. Erkek/kadın oranı 2,7/1 idi. 7 olguda komorbid hastalık mevcuttu. Karın ağrısı (%72.7) en sık gözlenen semptom iken histopatolojik değerlendirmede 9 olguda heterotopik doku izlendi. Postoperatif cerrahi komplikasyon 6 hastada izlenirken en sık gözlenen komplikasyonun ileus (3 hasta) olduğu saptandı. Postoperatif süreçte bir hastada mortalite gözlendi. Sonuç: MD akut batında ayırıcı tanıda her zaman akılda bulundurulması gereken patolojilerdendir. Tanıda gecikilmesi ve ameliyat esnasında gözden kaçması özellikle semptomatik olan hastalarda ve başka akut batın sebepleri ile ilişkilendirilebilen patolojilerde mortalite ve morbidite oranlarını artırmaktadır.

Anahtar Kelimeler

• Meckel divertikülü
• divertikülit
• akut batın
• ince bağırsak rezeksiyonu

Symptomatic Meckel's Diverticulum in adult patients: our single center 6-year clinical experience and results

Öz

Aim: Meckel's diverticulum (MD) is an embryological remnant that results from the incomplete obliteration of the omphalomesenteric or vitelline duct after birth and it is the most common congenital anomaly of gastrointestinal tract. MD is usually asymptomatic and presents in the pediatric population. In this study, it was aimed to analyze the clinicopathological characteristics of MD, which has an important place in the differential diagnosis of acute abdomen and is difficult to diagnose in the preoperative period, in the light of current literature and to examine the results Material and Methods: Patients diagnosed with Meckel's diverticulum and underwent surgery between January 2017 and January 2023 in the general surgery clinic were retrospectively scanned. Preoperative, intraoperative and postoperative data of the patients were examined and analyzed. Results: Sixteen of the cases were male and 6 of them were female. Comorbid disease was present in 7 cases. Abdominal pain (72.7%) was the most common symptom, while heterotopic tissue was observed in 9 cases in histopathological evaluation. Postoperative surgical complication was observed in 6 patients and the most common complication was found to be ileus (3 patients). Mortality was observed in one patient in the postoperative period. Conclusion: Meckel's diverticulum should always be kept in mind in the differential diagnosis of acute abdominal pain. Delay in diagnosis and going unnoticed during surgery increase mortality and morbidity rates, especially in symptomatic patients and pathologies associated with other causes of acute abdomen.

Anahtar Kelimeler

• Meckel
• diverticulitis
• acute abdomen
• small bowel resection

Kaynakça

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