Meckel's diverticulum with hemorrhage: a retrospective analysis of 72 cases

Shaosong YE; Hong ZHANG; Yongjun LIU; Shiheng CHEN; Hui LIN; Jianying BAI; Shiming YANG; Chaoqiang FAN

doi:10.16016/j.2097-0927.202202160

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Meckel's diverticulum with hemorrhage: a retrospective analysis of 72 cases

Clinical Medicine | 更新时间：2026-01-09

- Meckel's diverticulum with hemorrhage: a retrospective analysis of 72 cases
- Journal of Army Medical University Vol. 44, Issue 13, Pages: 1385-1389(2022)
- 作者机构：
  
  1.400037 重庆，陆军军医大学(第三军医大学)第二附属医院消化内科
  2.637000 四川南充，川北医学院附属医院消化内科
- 作者简介：
- 基金信息：
  
  the Special Project of Science and Technology Innovation Capacity Promotion of Army Medical University(2019XLC1008)
- DOI：10.16016/j.2097-0927.202202160
  CLC： R442.7;R444;R574.5
- Received：26 February 2022，
  
  Revised：2022-03-22，
  
  Published：15 July 2022
- 稿件说明：
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Shaosong YE, Hong ZHANG, Yongjun LIU, et al. Meckel's diverticulum with hemorrhage: a retrospective analysis of 72 cases[J]. Journal of Army Medical University, 2022, 44(13): 1385-1389.
DOI：

Shaosong YE, Hong ZHANG, Yongjun LIU, et al. Meckel's diverticulum with hemorrhage: a retrospective analysis of 72 cases[J]. Journal of Army Medical University, 2022, 44(13): 1385-1389. DOI： 10.16016/j.2097-0927.202202160.

摘要

目的

探讨Meckel憩室(Meckel’s diverticulum

MD)并出血的临床特征、病理及预后相关分析。

方法

回顾性分析陆军军医大学第二附属医院2009年11月至2020年11月期间经肛单气囊小肠镜(single balloon enteroscopy

SBE)诊断72例MD并出血患者的临床资料、内镜特点及术后病理类型。

结果

① 72例患者临床均表现为反复便血，病程最短4 d，最长27年；其中男性59例(82%，59/72)，女性13例(18%

13/72)；年龄13~59(27.92±11.15)岁；血红蛋白浓度29~162(93.86±27.66)g/L；憩室距回盲瓣距离32~150(90.90±30.79)cm；②56例患者(77.8%，56/72)接受了外科手术治疗，15例患者(21%，15/72)接受了内科保守治疗，1例患者(0.1%，1/72)接受了介入治疗；外科组手术方式为: 憩室整体连同局部肠管切除15例(26.8%，15/56)，憩室局部楔形切除41例(73.2%，41/56)；③外科术后再出血占16.1%(9/56)，内科保守治疗后再出血占33.3%(5/15)，单因素分析显示外科术后再出血危险因素与手术方式不相关；④外科术后病理提示: 憩室伴慢性炎症38例(67.8%，38/56)、憩室伴异位胃黏膜14例(25%，14/56)、憩室伴异位胰腺2例(3.6%，2/56)及憩室伴血管畸形2例(3.6%，2/56)。

结论

Meckel憩室诊断较困难；Meckel憩室外科手术术后再出血率明显低于内科保守治疗，外科术后再出血风险与手术方式无关；Meckel憩室术后病理学以慢性炎症和组织异位为主。

Abstract

Objective

To explore the clinical features

pathology and prognosis of Meckel's diverticulum (MD) with bleeding.

Methods

Clinical data

endoscopic characteristics and postoperative pathological types of 72 patients who were diagnosed with single balloon enteroscopy (SBE) in the Second Affiliated Hospital of Army Medical University from November 2009 to 2020 were collected and analyzed.

Results

① The 72 patients manifested as recurrent hematochezia

with a course lasting from 4 d to 27 years. They were 59 males (82%

59/72) and 13 females (18%

13/72)

at an age from 13 to 59 (27.9±11.15) years. The hemoglobin level ranged from 29 to 162 (93.86±27.66) g/L. Anal SBE showed the diverticulum was 32 to 150 (90.90±30.79) cm from the ileocecal valve; ② Among them

56 patients (77.8%

56/72) underwent surgical treatment

15 patients (21%

15/72) received conservative medical treatment

and 1 patient (0.1%

1/72) took interventional treatment. The operation procedures included resection of the diverticulum and partial bowel in 15 patients (26.8%

15/56) and wedge resection of the diverticulum in 41 cases (73.2%

41/56); ③ Rebleeding was observed in 9 cases after surgical operation (16.1%

9/56) and in 5 cases after conservative treatment (33.3%

5/15). Univariate analysis showed that the risk factors of rebleeding after surgical treatment were not related with surgical procedures; ④Postoperative pathology indicated that diverticula with chronic inflammation accounted for 67.8% (38/56)

diverticulum with ectopic gastric mucosa for 25.0% (14/56)

diverticulum with ectopic pancreas for 3.6% (2/56) and diverticulum with vascular malformation for 3.6% (2/56).

Conclusion

MD is hard to diagnose. Surgical treatment obtains significantly lower rebleeding rate than conservative treatment

and the risk of postsurgical rebleeding is not related to the surgical procedures. Pathological study shows that MD is mainly chronic inflammation and heterotopic tissue.

关键词

Keywords

references

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