Divertículo de Meckel

Conteúdo do artigo principal

Priscilla Domene Vaccaro Silva
Victor Hugo Lara Cardoso de Sá
Vicente Antônio Gerardi Filho
Luciana Trindade Godinho
Fabyane Sanches
Pedro Muñoz Fernandez

Resumo

O divertículo de Meckel (DM) resulta de uma obliteração incompleta do ducto onfalomesentérico ou vitelino. É constituído por conduto aberto na porção intestinal e fechado acima desse até a cicatriz umbilical. O DM é considerado a anomalia congênita gastrintestinal mais comum, sendo a causa mais freqüente de sangramento gastrintestinal baixo significante na criança, por se localizar no intestino delgado, na borda antimesentérica do íleo, geralmente a 100 cm da válvula ileocecal. A maioria dos indivíduos com DM são assintomáticos. As apresentações clínicas mais observadas são: hemorragia digestiva, obstrução intestinal e diverticulite. A confirmação diagnóstica de DM deve ser iniciada com radiografia simples de abdome, enema baritado e tomografia computadorizada, visando a afastar outras afecções. A ultra-sonografia é indicada nos casos de sangramentos retais e cintilografia negativa. A cintilografia com tecnésio 99 é o método mais utilizado para detectar o DM, com especificidade de 95-100% e sensibilidade variando de 50-92%. A laparoscopia exploradora pode ser usada como método diagnóstico e tratamento somente nos casos em que não existe grande distensão intestinal. O tratamento do DM é essencialmente cirúrgico, por meio de cirurgia aberta ou laparoscópica, incluindo diverticulectomia simples ou ressecção ileal.

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