成人美克耳憩室49例诊治分析

Diagnosis and treatment of adult Meckel's Diverticulum:Report of 49 cases

目的探讨成人美克耳憩室的临床表现、诊断及治疗方法，以提高成人美克耳憩室的诊治水平。方法对我院1995年4月-2005年4月收治的成人美克耳憩室49例的临床资料进行回顾性分析。本组病人均经手术治疗。其中，行憩室切除加小肠部分切除32例，憩室切除加小肠楔形切除11例，腹腔镜辅助憩室切除加小肠部分切除6例。结果本组病例病理检查结果显示，美克耳憩室内有异位胃组织者21例，有异位胰腺组织者2例。本组病例均治愈出院。随访6月～10年，疗效满意。结论成人美克耳憩室主要表现为下消化道出血、急性憩室炎或小肠梗阻，无论有无临床症状，一经确诊，均以手术治疗为宜。腹腔镜可作为诊断和治疗成人美克耳憩室引起消化道出血的常规方法。

Objective To investigate the clinical manifestation,diagnosis and treatments of adult Meckel＇s diverticulum. Methods The clinical data of 49 cases of adult Meckel＇s diverticulum were analyzed retrospectively from April 1995 to April 2005. All patients were treated by surgical treatments, including diverticulum resection and enterectomy in 32 cases, diverticulum resection and wedge enterectomy in 11 cases,and laparoscopic assistant diverticulum resection and enterectomy in 6 cases. Results Pathological examination revealed that 21 cases（42. 8%）had ectopic gastric tissue and 2 cases （4. 1%）had ectopic pancreatic tissue in diverticulums of these patients. All patients were cured. During a follow-up period of 6 mouths to 10 years, the curative effectiveness was satisfactory. Conclusion Adult Meckel＇s diverticulum is mainly manifested as hemorrhage of inferior digestive duct, acute diverticulitis or intestinal obstruction. It is suggested that early operation of adult Meckel ＇ s diverticulum should be done as soon as this disease was diagnosed. Laparoscopy is a feasible and reproducible procedure in the diagnosis and treatment of adult patients with Meckel＇s diverticulum.