WHAT MAKES A MECKEL’S DIVERTICULUM COMPLICATED: A RETROSPECTIVE ANALYSIS OF 39 CASES

Introduction: Despite the progress of the medical diagnostic and therapeutic tools at our disposal, complicated Meckel’s diverticulum (MD) still represents a challenge for surgeons1. Aim of this study was to review the outcomes of patients who underwent surgery for complicated MD and compare histological results of incidental MD. Material and methods: We reviewed 39 patients who underwent surgery for a MD from 2005 to 2016. Twelve of them (31%) showed complicated MD (Group A); the remaining 27 (69%) had an incidental MD (Group B). In the first group, main outcome measures included type of surgery performed, convertion rate, type of resection, mean operative time, postoperative course, morbidity, mortality. Hystopathological results were compared. Results: Eight patients (67%) had abdominal pain, three (25%) bowel obstruction and one (8%) gastrointestinal bleeding. Mean BMI was 25.8 kg/m2. A preoperative diagnosis of complicated MD was carried out only in one case (8%). 11 patients (92%) had laparoscopy. Conversion rate was 18%. Tangential resection with stapler was performed on 92% of patients. Mean hospital stay was 6.6 days.Morbidity was 25%. No deaths were recorded. An MD normal enteric-type was found in 33.3% (n=4), an enteric-type MD with flogosis and/or necrosis in 50% (n=6) and 16.7% (n=2) showed a Gastric mucosa-type MD. No significant differences, in terms of histological findings, were found in the group with an incidental MD. Conclusion: Definitive diagnosis of complicated MD can be made during surgical exploration. Laparoscopy might have a crucial role in the diagnostic-therapeutic algorithm, and tangential resection may allow a complete removal of ectopic tissue. References: 1. Park JJ, Wolff BG, Tollefson MK, Walsh EE, Larson D. Meckel diverticulum: The Mayo Clinic experience with 1476 patients (1950-2002). Ann Surg, 2005; 241: 529-33. Disclosure: No significant relationships.