DIAGNOSIS AND TREATMENT OF MECKEL DIVERTICULUM COMPLICATIONS IN CHILDREN

Abstract

Meckel diverticulum is a congenital abnormality of the intestinum appearing due to the failure of the vitelline duct closure. Meckel diverticulum may have no clinical signs however in 20-25% its complications may cause different acute surgical conditions demanding surgical interventions. These complications may appear with the symptoms of abdominal pain, intestinal hemorrhage and intestinal obstruction. The aim of the study was to analyze the results of treatment of Meckel diverticulum complications in children. We have analyzed the results of diagnostics and treatment of 69 children aged between 10 months and 13 years. All the children were admitted to the surgical department of Samara Regional Clinical Hospital named after V.D. Seredavin between 2013 and October 2020. The presented complications of Meckel diverticulum were: diverticulitis (37), intestinal bleeding (17), intestinal volvulus (9), intestinal obstruction (3), intussusception (3). Most frequently the complications were present in infants and preschool children. All the patients underwent clinical, laboratory, ultrasound, X-Ray (when necessary) and intraluminal endoscopic (when necessary) examinations. However, in most cases complications were diagnosed during laparoscopy. All the children underwent surgical treatment. Most of the surgeries were laparoscopic (54, 35 of them were video assisted mini laparotomies). Two patients presented postoperative complications: anastomotic leaks; both of the children required repeated surgeries. The reasons of complications were underestimation of the paients’ conditions at the moment of surgical interventions and significance of the inflammatory process in the abdominal cavity. We employed ileostomies to those children which we closed 3 weeks after that when the general conditions were appropriate. We had no lethal cases. The average hospital stay was 11,6 days.