The Meckel's Diverticulum, Embryology to Surgery

Objectives. From a personal series of 217 pediatric cases and a meta-analysis of 8 389, the author made a study of the uniqueness embryopathogénique in clinical and surgical correlations.Results. With a frequency of 1.69% with a male General Sex Ratio 1.9, Meckel's diverticulum dominates the abdominal surgical pathology by its deceptive nature, «too often silent and discovered incidentally, that loud and updated at the opportunity of a complication». The author focuses on the forms «variants», in particular the «Meckel equivalent» DM «at minimum», DM «plated», «mesenteric included or also called DM intraluminal», each form can cause its own complications. Mechanical complications (intussusception, volvulus diverticular axial or flange Littre hernia) remain the most frequent (62.7%). Hemorrhagic stroke, abrupt or insidious complement the complications, but there is no clinicopathological parallelism in the same way that no histo - clinical parallelism.Conclusions. Its clinical masks and diagnostic pitfalls can be appreciated by applying the «Rule of 2» applying to eight parameters (frequency, age, sex, clinic, office, size, diameter, heterotopia) in connection with the notion of «second appendix» of the ancient authors. Therapeutic rule should not not derogate from the dogma of the T resection with end to end anastomosis in open surgery, laparoscopy still only a great ally.