Preoperative Diagnosis of Symptomatic Meckel’s Diverticulum
MECKEL’S diverticulum, with an incidence as high as 2 per cent,1 has been reported to be the most common congenital gastrointestinal anomaly. Nevertheless, mortality from symptomatic diseases of the diverticulum has been reported to be from 6 per cent to 21.6 per cent. 2–5 These high rates have been attributed to delay in diagnosis and in operation.
Concerning the diagnosis of symptomatic Meckel’s diverticulum little has been written except in the areas regarding exclusion of other causes of recurrent abdominal pain, peritonitis, intestinal obstruction, or rectal bleeding. The differential diagnosis usually includes appendicitis, mesenteric adenitis, worms, intestinal hemangioma, polyp, food allergy, recurrent intussusception, intestinal duplication, allergic purpura, and anal fissure.
The variety of descriptions of the pain associated with symptomatic Meckel’s diverticulum leads one to conclude that periumbilical pain is usual although not pathognomonic. The differential diagnosis between bleeding from the Meckel’s diverticulum and some of the more common causes of gastrointestinal bleeding in young patients, such as anal fissure, polyps, intussusception, and duodenal ulcer has been thoroughly described. In an attempt to find the most commonly associated symptoms in patients with proved symptomatic Meckel’s diverticulum, a survey of records of patients was undertaken in order to aid earlier diagnosis and operation, and thereby reduce the mortality.
The records of 24 patients in whom the diagnosis of Meckel’s diverticulum was proved by operation between 1928 and 1958 comprise the series. All age groups were included in order to provide maximum opportunity for comparison of symptom patterns. The. . .