THREE CASES OF MECKEL'S DIVERTICULUM IN THE ADULT

Meckel's diverticlectomy was performed in three patients from 1983 to 1989 in this hospital. An axial volvulus associated with acute peritonitis was occurred in one of the three cases.A 27-year-old man was admitted with the complaints of severe vomiting and lower abdominal pain. Laparotomy of emergency revealed a large amount of turbid ascites and inflammatory necrotic Meckel's diverticulum with a band of fatty tissue adhering to the mesentery. The tumesent diverticulum, measuring 7 cm in length and 2 cm in diameter was located at approximately 40 cm from the ileocoecal valve and twisted on itself at a point near its base. Meckel's diverticulectomy and rational prophylactic appendectomy were performed with peritoneal drainage. This uncommon torsion is occurring in only 2.4-3.8% of patients complicated with Meckel's diverticulum. Incidental diverticulectomy was performed in 2 patients undergone cholecystectomy and appendectomy respectively, because they might be belonging to high risk group of complications from Meckel's diverticulum. Indication of Meckel's diverticulectomy is a conflicting matter in the asymptomatic patients. We are standing against the prompt excision as soon as after it is detected, however, sometimes no treatment leads to a fatal outcome. The careful criteria should be established to perform prophylactic excision of the asymptomatic Meckel's diverticulum detected incidentally during abdominal operation.