title: Acute symptomatic Meckel diverticulum management. Our experience on seven consecutive cases.
abstract: Meckel's diverticulum (MD ) is the most common congenital anomaly of the gastrointestinal tract. We revalued clinical records of patients discharged from Unit of Urgent and General Surgery of Highly Specialized Hospital "A.O.R.N. Antonio Cardarelli" of Naples with diagnosis of acute pathology associated to complicated MD from 1(st) January 2011 to 30(th) November 2012. Seven consecutive cases have been chosen: five males (71,4%) and two females (28,6%). The age ranges over from 13 to 50 years with a 28 years average. Four of them were submitted to emergency surgical intervention for hemorrhage from gastro-enteric tract (57%), two for bowel obstruction (29%) and one for acute appendicitis (14%). In all cases sample was send to histological examination. Two samples showed normal epithelial mucosa. Four of them showed ectopic mucosa inside the diverticulum: three gastric and one pancreatic ectopic mucosa focal areas. The last case showed normal epithelial cells but with ulcerated and hemorrhagic areas. Four samples of patients with hemorrhage from gastroenteric tract showed at histological examination: a case of normal mucosa, a case of gastric mucosa areas, one of pancreatic ectopic tissue and the last with normal mucosa but ulcerated and with bleeding areas.In our experience we never speculated that acute symptomatology depended on complicated MD and diagnosis was always done during laparotomy. We think that MD removal is always the correct choice, so that future complications such as neoplasm can be avoided. MD simple resection by Stapler at the base of diverticulum is the correct choice.
authors.forename: Umberto
authors.initials: U
authors.lastname: Robustelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Manguso
authors.forename: Mariano Fortunato
authors.initials: MF
authors.lastname: Armellino
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Mannelli
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Massa
authors.forename: Anna Lucia
authors.initials: AL
authors.lastname: Forner
authors.forename: Roberto
authors.initials: R
authors.lastname: Bellotti
authors.forename: Francesco
authors.initials: F
authors.lastname: Ambrosino
authors.forename: Beatrice Ulloa
authors.initials: BU
authors.lastname: Severino
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001064:Appendicitis / Q000150:complications / Q000601:surgery; D002828:Choristoma; D003952:Diagnostic Imaging / Q000379:methods; D013505:Digestive System Surgical Procedures / Q000379:methods; D019468:Disease Management; D004238:Diverticulitis / Q000473:pathology / Q000601:surgery; D004630:Emergencies; D005260:Female; D005753:Gastric Mucosa; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D007813:Laparotomy; D008297:Male; D008467:Meckel Diverticulum / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D010179:Pancreas; D011859:Radiography; D012189:Retrospective Studies; D014456:Ulcer / Q000209:etiology; D055815:Young Adult