Comparative Study on the Characteristics of Meckel’s Diverticulum Removal from Asymptomatic and Symptomatic Patients: 18-Year Experience from Thailand’s Largest University Hospital
Varut Lohsiriwat MD, PhD*, Thana Sirivech MD*, Mongkol Laohapensang MD**, Ananya Pongpaibul MD***
Affiliation : * Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand *** Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To report an experience with Meckel’s diverticulum (MD) from a University Hospital in Thailand, and to compare
the characteristics of MD removal from asymptomatic patients and symptomatic patients.
Material and Method: The authors retrospectively reviewed the medical records of patients undergoing the resection of
MD between January 1994 and July 2011 at the Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok. The
patients were subsequently divided into two groups. The asymptomatic group included individuals with MD that were found
incidentally during the course of laparotomy performed for reasons not related to the complications of the MD. The
symptomatic group included individuals presenting with complications related to the MD. Data were recorded including
patient’s demographics, clinical presentation, histopathologic findings, and postoperative outcomes.
Results : The present study included 84 patients (53 males, 63%). Of whom, 60 patients (71%) were pediatric (age <16 years)
and 51 patients (61%) were symptomatic. The most common presentation of symptomatic MDs in pediatric and adult patients
was lower gastrointestinal bleeding and mechanical small bowel obstruction, respectively. The correct preoperative diagnosis
of MD was made in only 20 patients (39%) of the symptomatic group, all with 99mTc-pertechnetate scanning. The MDs in
the symptomatic group were significantly longer with a wider base than those in the asymptomatic group, 3.2 vs. 2.0 cm in
length (p = 0.001) and 1.8 vs. 1.0 cm in width (p<0.001). Ectopic tissue was present more significant in the symptomatic
group than in the asymptomatic group (51% vs. 12%; p<0.001). None of the resected MDs contained neoplasm. There was
no significant difference in the morbidity or mortality rate between the symptomatic and asymptomatic groups.
Conclusion : The MDs in the symptomatic patients were significantly longer with a wider base than those in the asymptomatic
patients. Symptomatic MDs contained ectopic tissue more frequently than asymptomatic MDs.
Keywords : Meckel’s diverticulum, Surgery, Outcomes, Incidental finding, Ectopic tissue, Small bowel obstruction, Gastrointestinal bleeding, Thailand
