Дивертикул Меккеля: варианты строения

Abstract

Abstract Background: Meckel’s diverticulum (MD), ileum diverticulum, is a congenital anomaly caused by incomplete reverse development of the vitelline duct and manifested by a protrusion of the ileum [1]. Lack of awareness of MD and the absence of specific symptoms in most cases can lead to initial diagnostic errors and wrong treatment tactics. This, along with a serious prognosis of complications in MD and a mortality which varies between 5 – 10% [2], determines the clinical relevance of this study. The purpose was to study the structure of MD in light of the anatomical prerequisites for the formation of related complications. Material and methods: The structure of MD was studied through a retrospective analysis of 36 medical cards, anatomical preparations and literature sources. Results: As the result of a retrospective analysis of medical histories, it was found that in all cases of recorded MD its specific clinical symptoms were absent, which led to diagnostic difficulties. In all patients, MD was diagnosed only after the development of complications, during an emergency laparotomy with the background of the patient’s serious general condition. This combination led to a fatal outcome in two cases. In the anatomical preparations reviewed, MD varied in length (70, 20, and 40 mm, respectively) and shape [3]. Conclusions: MD was characterized by structural variants (elongated MD, the presence of its own mesentery, constrictions and heterotopic gastric tissue), predisposing to the development of complications. The absence of specific symptoms determines the manifestation of MD already at the stage of severe complications. The unfavourability of prognosis in the development of complications justifies the dynamic observation of patients with MD and the timely treatment of this pathology.