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Meckel's diverticulum in adults: retrospective analysis of 119 cases and historical review.

OBJECTIVE: To publish our experience in the management of Meckel's diverticula in adults, and compare our results with those published elsewhere.

DESIGN: Retrospective investigation of casenotes.

SETTING: Multicentre study, Switzerland.

SUBJECTS: 119 patients aged over 16 years who had Meckel's diverticula resected between 1980 and 1997.

MAIN OUTCOME MEASURES: Assessment of the usefulness of various investigations and the criteria for removing asymptomatic diverticula.

RESULTS: 67 diverticula (56%) were resected during laparotomy for another cause, and 52 (44%) for symptoms caused by the diverticula. In both groups the condition was more common in men, and most likely to present during the fourth decade. The most common investigation in the 52 symptomatic cases was a plain film of the abdomen (n = 47, 90%), and in none was a Meckel's diverticulum suggested as the cause of the symptoms. The success rates of other investigations were: small bowel enema 4/9, 99mTc scan 3/4, angiography 1/3, and computed tomography 1/14. No ultrasound scans were done. Our results compared favourably with those reported elsewhere, with no deaths in either group, 2 complications that required reoperation in the incidental group, and 1 in the symptomatic group.

CONCLUSIONS: The criteria to be taken into account when deciding to resect an asymptomatic diverticulum are: male sex, age <40, ASA score, the operation being done, the size and position of the diverticulum, whether it is palpable, and whether there are other reasons for the patient's complaints.

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