Abstract
An: 2017, Nr.2, Articol Nr. 4
Title: 

ANATOMO-SURGICAL CORRELATIONS IN MECKEL’S DIVERTICULUM VERSUS JEJUNAL DIVERTICULUM

Authors: 

      Claudia Stoica, Ileana Giuvarasteanu - “Carol Davila” University of Medicine and Pharmacy Bucharest, Department of Anatomy
      N. Bacalbasa - “Carol Davila” University of Medicine and Pharmacy Bucharest, Department of Obstetrics and Gynecology
      R. Costin - “Carol Davila” University of Medicine and Pharmacy Bucharest, Ilfov Clinical County Hospital Bucharest, General Surgery Department
      Madalina Marcu - “Carol Davila” University of Medicine and Pharmacy Bucharest, Department of Pathological Anatomy
      Irina Balescu - “Carol Davila” University of Medicine and Pharmacy Bucharest, Ponderas Hospital Bucharest
      ANATOMO-SURGICAL CORRELATIONS IN MECKEL’S DIVERTICULUM VERSUS JEJUNAL DIVERTICULUM (Abstract): According to the literature, the Meckel’s diverticulum arises from the antimesenteric side of the ileal loop, and the first description of a Meckel’s diverticulum located on the mesenteric side was reported by Chaffin (1941). Whenever an intestinal diverticulum is found intraoperatively, the differential diagnosis with jejunal diverticulum and enterogenous cyst must be considered. The incidence of acquired jejunal diverticulum varies from 0.2 to 1.3%, and usually it is asymptomatic and is diagnosed incidentally during laparotomy. Therefore, the surgical decision must be resection of the diverticulum even if the lesion is detected incidentally during surgery. Methods .Considering these, we present two patients with Meckel’s diverticulum with atypical location (Littre hernia) and jejunal diverticulum identified during surgery for intestinal obstruction (due to a phytobezoar in the intestinal loop containing the diverticulum), respectively. Both diverticula were located on the mesenteric side of the intestinal loop. Results. We demonstrated on intraoperative images that the mesenteric side location of the diverticulum can be dangerous because of the serious complications caused by an inflammatory process involving the diverticulum. The only surgical technique recommended in these cases was resection of the intestinal loop containing the diverticulum. Conclusion: Meckel’s diverticulum lies on the antimesenteric border of the distal ileum, opposite to the superior mesenteric artery termination, while the jejunal diverticulum is located above the termination of the superior mesenteric artery and both are usually asymptomatic. In contrast to Meckel’ diverticulum, jejunal diverticulum is an acquired diverticulum and may be the consequence of multiple and recurrent abdominal inflammations. In both cases surgical resection of the intestinal loop containing the diverticulum is required.
Key words: MECKEL’S DIVERTICULUM, JEJUNAL DIVERTICULUM, LITTRE HERNIA
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