Page 1
= Abstract =
A clinical Study of Vitelline Duct and Vessel Remnants
Jae Young Choi, M.D., Poong Man Jung, M.D.
Department of Surgery, Hanyang University, College of Medicine
Seoul, Korea
Of 72 patients with vitelline duct and vessel remnants, 45 (62.5 %) had symptomatic lesions. The mean age of the patients was 27.9 months. Males predominated (4.6 : 1). There were 22 cases of Meckel's diverticulum, 6 of Meckel's diverticulum attatched to the umbilicus with a fibrous band, 6 cases of patent vitelline duct, 5 cases of vitelline artery remnants as a fibrous band and 2 cases each of umbilical sinus and polyp, and vitelline cyst. Twenty-three patients (51 %) presented with intestinal obstruction, 6(13 %) with rectal bleeding, 4(9 %) with perforated Meckel's diverticulum, 5 with intestinal juice drainage through umbilicus, 5 with umbilical lesions, 1 with abdominal mass, and 1 with sepsis. Intestinal obstruction due to fibrous band developed during infancy(average age; 4.6 months). Seventeen asymptomatic Meckel's diverticulum, 8 obliterated vitelline artery remnants and 1 vitelline vein remnant as fibrous band, and 1 vitelline cyst were found incidentally at laparotomy. About 82 % of the complicated Meckel's diverticulum presented in infants and children less than 4 years of age.
Index Words: Vitelline duct remnant, Omphalomesenteric duct remnant, Vitelline artery rem
nant, Vitelline vein remnant
'd~'ct~ ~:§j-~% '?1 ~ "5"H:- Ell °r~ ~jAJ:Ul2f~ ~ Ell ).~71 ~15~7'TOJ1 J1j1~£loj, Soderlund1=- 01 cHi :1J~3j'tl ~~ ~:1J°1 :1J A1£l1=- B7-l1OJ1 u:j-c.j
~j;"J:Ul2f~ ~ ~~ ~*ol AJ% oj -)i 7rA1 ~ 'T£
t+T~ql. '?1TA~OJ1 ~~ cj-~~ ~rol1=- 'U.Q.t+ -¥-~% 5'.t:H~ tl: '?1-T~~ {!;:(11 'tl-T~ ~ 2 %~ 75.!f-OJ1 "1 ~l;;<J:Ul2f~ ~*%ol ~A~"5"}Jl 01£ 'tl"5"}
oj ojc~ 7}:A1 ~~ ~% *~"5"}oj, :J.. Jil£::: 2J.~1
01{!OJ1::: ~.Q.oj t+017} l'i"0}~9-~ {}~"5"r1=- -3!.Q. ~ ~~~ 'U r:p-4.
1979\1 9~-¥-F~ 1997\1lJ}A1 12~lJ}A1 tl:0Jt:J1~
jjl -¥-4;-~~ ~0}~~OJ1 "i ~l~J:Ul2f~ ~ ~~ ~
*ol AJ~ ~~ ~~.Q.~ 9-~% ~~li:i 45il119f q
- 27-
Page 2
Table 1. Demogrphy of 72 Cases of the Vitelline Duct and Artery Remnants
Age(month) Symptomatic Asymptomatic
Male
Under 1 8
1 to 24 15
25 to 48 7
Over 49 7
Total 37
~ ~~..Q.s. yi' ~ -'f-~<5"] ~7,1"8 27aj].9] ~o}~
r1P'J..Q.5!.., 61 ~.9] ~~7.1 '3<1 <lJ,+~, ~.9]~-3j ~
7,1, S:3J~2.1 7,:lJ..}~:i!} ~% ~~J-3j..Q.5!.. ~~, .Jl~
i5}~q.
AllAJ{}~-B- '3<1 ~-B- ~*O]AJO] ~~ 72ajl.9] ~
o} ~ ';:f1..=j{}.9] ~""~tll%~ 3: 15!.. ';:fo}oJ]--'l ~~
q. 01 ~ ~AJ ~~..Q.5!.. Yi'~ ~.g. ~o}~ 45aj]
(62.5 %)~..Q.t9, ';:fO}7} 37aj], a:jO}7} 8aj]5!.. ';:fL=j
tll~ 4,6:1 omq. -'f-~<5"] ~7,1"8 27aj] ~ ';:fo}~
17aj]5!.. ';:fl..=jtl]-i::- 1.7:15!.. ';:fo}oJVi -'f-A~]i5}~q. ~
~~..Q.5!.. ~AJ% t.+E.}'iR ~0}~.9] ~"5-lf-±~ A~~
3~-!f-El 14A~] 107R-%l7J}7.] qOJi5}~..Q.t9, na-rr~"5
~ 27.97R-%l (SD=38.1) 0mq. 0] ~ 2A~1 0]i5}7}
64 %.9] 1fls:.~ Ji!..~..Q.t9, 4A~] 01i5}.9] ~o}oJl--'l
84 % 5!.. r11-!f--lf- ~ ~}7.1 i5}~ qUI 1, 2).
~~<5"] ~7,1"8 27aj](37.5 %)~ Meckel-Y-l 711{l
01 17ajl ~..Q.t9, ~~p,cJ ~%r11 9aj]~ 8aj]-i::- All AJ{}
~-B- %~.9] ~%%01~.Jl 1 ajl~ AllAJ{}~ ~~.9]
Female Male Female
1 9 8
5 5 2
2 0 0
0 3 0
8 17 10
~%%Ol~q, J 9J Al]AJn~-B- '3-~0] 1 ajl~q.
yi'% Ji.i5} 711 "8 .«:l iQl ~~.g. 5:l1 ~Jo 1 7 ajl 5!.. 7}AJ
*~..Q.t9, J q~..Q.5!..~ .!f1~:rr}~01 5ajl. ~~FcJ
~~5:l1~4~~..Q.t9, ~~~Ali~~~, ~~~~,
~~ 7R<lJ""cJ .R~-B-:i!} %Jtl-~ 7S-'f-7} Z{Z{ 3ajl~..Q.
t9, J 9J AJ'F~~, A~l*(omphalocele), ~7S~
l~PJ %Ol~qUl 3). AJ~~~ ~o} 2illloJl--'1 ~ AJ
~~~:i!} .!f--B-i5}711 Meckel-Y-l 711{l01 ~7,1£j~q.
~AJ ~~ ~ t.+E.}'iR Al1AJ{}~-B- ~*%~.9] ~*
-i::- Meckel-Y-1 711 {l 01 28ill](62 %)5!.. 7}AJ *~..Q.
Pi, J qg..Q.5!.. ~~ 7HlolJAcJ AlJAJ{}~-B-0] 6 ill]
(13 % )~q. J 9J Allr11%~, All % (umbilical
sinus), '3<1 AljAJ{}~-B- '3-,%01 Z{Z{ 2illl(4 %)oJl--'l
t.+E.});J;q. All AJ{}~-B- %~.9] ~%%'t! ~%r11 ~ 5
illl(11%)~qOE 4). ~~11 Meckel-Y-l 711{l.9] 1fls:. ~ ~T71{}~ ~.«:l ~0}9J:i!}oJ1J..l }.lis~~ 7R.J;l-i'
~ 2,272illl ~ 45ajJoJl--'1 ~7,1£joj 2 %.9] 1fls:.~
Ji!..~q,
~AJ~~~ 71711-3j AJlEll5:l17} 23ill](51 %)s. 7}
AJ *~..Q.Pi, J q%..Q.5!.. Al1r11-lf-tll (9aj]), ~~ (6
ill]), ~.:g-..Q.s. 't! ~ .J;l-~~ (5 aj]), All r11 i5} <lJoJl--'l
~7.1"8 ~Jlj(1ill]), '3<1 jiJj~~(1ill]).9] tr°l~q. 71
711-3j AJlEll5:l1 ~ Meckel -Y-l 711 {l5!.. 't! ~ ::<J~~ ~ 01
12ajl5!.. 7}::<J *~..Q.t9, ~~}.cJ ~%r115!.. 't!~ AJlEll
Table 2. Age Distribution of Comlications of Meckel's Diverticulum
Age (month) Int, obstruction Bleeding Perforation
Under 1 0 0 0
1 to 24 11
25 to 48 3
Over 49 4
Total 18
3
3
0
6
- 28-
1
2
1
4
Total ( %)
O( 0)
15( 53.6)
8( 28.6)
5( 17,8)
28(100)
Page 3
Table 3. Associated Diseases of Vitelline Duct and Artery Remnants(N = 27)
No. of diseases
Imperforate anus 7
Gastroschisis 5
Intestinal atresia 4
Patent urachus 3
Annular pancreas 3
Hirschsprung's disease 3
Intestinal malrotation 3
Omphalocele 2
In tussnscepti on 2
Conjoined twin 2
Asplenia syndrome 1
Diaphragmatic hernia 1
Wilms' tumor 1
Umbilical hernia 1
Renal agenesis 1
Spina bifida 1
Sl17} 1l?l1(711~4 ~~'8 '1l%rJl 611], /\lP<J~~-B
% ~ 9.J ~%% 5?l1) ~ q . 01 % 2 ?l1 011 Arc <:1. ;~.J.l'c] '1l%rJl~ Aj{l.Q.~ ~A~~ AJ~~Ziom.Q.uj, 1?l1 ~ '~PJ Y11~PJOm.:lL y.Dl7,1 8?l1~ <:1.~:FC] '1l%rJl 011 9.J~ AJ-B-9.J ~~omq, 711113j AJ]!j1 Sl1~ 2A-11
u1'D:011 Al 70 %(l6?lD9.J 'it~ 01-¥1:%% '!;!'~.Q.uj,
!1ait ~'i5.g- 25.47B-%HSD =35,2)019iq. AJiEl1s:~9.J
.<f:l,{}01 /\PJ~~-B- %~9.J <:1.{i/'c] )iH;-J:H~~ ~~
7cl-'i'-011Al~ !1ait~'i5°1 4.67~-%l..£ '7t~.Q.y., 01011 tl1i;~ AJ%rJl7} Meckel ""1 711~4 %~s:1ol y.E.}\:!: 7cl-'i'-011Al~ !1ait~'i5°1 47.57~-%l.~ l!1{:! 'it~q.
6?l19.J Meckel ""1 711~~~~ ~1(1. :E.~ <:1.~1(1.%
"r±~ Y1.<f:lt}~q . Y1.<f:l cJ- A1 !1ait ~~±7.1~ 8.0gm/dl(SD=2.0)~.Q.uj, J1r71~AJ 4?l1011 Al 2-3 :§:j.9-1 AJ ~ ~ 9.J ~ ~ 01 'U 9i q. 6?l1 % 5?l1 011 Ai ~ 99mTc-pertechnetate ~ 01 % ~ Meckel ""1 711 {l "rAr ~ {llj01 7Pg-t}S3,q. y.uj7.1 lal1011Ale 99mTc_ pertechnetate "rA}9.} 3j ~T"rAHAl .2.f- %/,c] 01 9iq. T~ ~ ~?o1{lAVJ 4?l101H °1±),c] ~{l~ ~?01 01 '!;!'~.Q.uj, 01 % 1?l1 011),1 01 ±),c] ~11 AJ~?o1
01 %~s:19iqOI 5). ~7,r%9.J !1ait ~~.g- 25.7 7~-%l.(SD=13.3)019i.Q.uj, 3?lj(50 %)0111.1 2,J,11 01
AJ019iq. Meckel ""1 711 {l:t! --t'- 4?l1 % T~-'8 {l Bo 1 7} '0 ~
li:l 247~-%l.'8 \fore Y1.<f:l l\::!Zi :u~3jCj ~% ~ ~1(1.9.J 471~01 'U9i.Q.uj, Y1.<f:l l~Zi¥-Ele <:1.~
1(1., T£., ~%, ~ ~~±7.1 7.5 gm/dl9.J ~~±z:! % .!;!.O:j MeckeW1 711~9.J :t!--t'-.Q.~ Cj~ ~~~%
9.J{ltr~q. T~Zi {lB01 01 f-ol 7,17,1 \?i~ti 3?l1 % 1?l1 ~ Y1.<f:l 57~ -%l. Zi ~~3j Cj ~%.Q.~ qJ.<f:l 7.1
Table 4. Type of Symptomatic Vitelline Duct Remnants
Vitelline duct remnant
Meckel's diverticulum
leading point of intussusception
bleeding
diverticulitis with perforation
Diverticulum attached to the umbilicus with band
Patent omphalomesenteric duct
Umbilical polyp
Vitelline cyst
Umbilical sinus
Vitelline artery remnant as band
Vitelline vein remnant as band
Total
- 29-
No of cases
40
22
12
6
4
6
6
2
2
2
5
0
45
Page 4
- ~o}.2j~ : ~14 'tl ~11 I 199B\1 -
Table 5. Clinical Features of Bleeding Meckel's diverticulum
No. of Sex Age RI cases scan
1 F 11m + 2 F 1yr4m + 3 F lyr4m + 4 M 2yr6m
5 F 3yrlm + 6 M 3yrBm +
Hgb(fm/ dl
9.7
9.3
10.1
7.4
6.0
5.3
Previous bleeding episodes
two
none
two
three
none
three
Histologic findings
G(+)
G(+)/P(+)
G(+)
G(+)
RI scan: 99"'Tc-pertechnetate scan, G: Gastric mucosa, P: Pancreatic tissue
li 1il'.g. J1}7j~0] ~~ ~o}£., t.Jl~ 7~{!.!f-E~ ~
,A~~ {}~~ *~ ~ t.Jl~ 3~{!.!jLE~ *.!f-.ll}loJ, ~
£, ~ ~~o] ~~ ~~ t.Jl~ + ,A]"5~~ BJA}~"§{
~ {lA}AJ o}l:l],AJ ,AJiIfl11l :±.7,j ~ ..!i!-~..Q..uj *~78
73j, ~~, ~ Jflli %91 *l2}~ ~,\~] ~ .!to:j g i:f 7~*~+ ~~¥l Meckel~ ill 11. g ~7,j%}~q. t+
o-J-,,] 2 ill] 'F 1 ill]~ ,AJ'F{l~..Q..£. ~ Jt! 1il'.Jl l:l}c.j % 78* 1 ~ ~ 7-l]4r~ ~ *~~ ~~ol ~~ ,AJ~~
91 {l %}oJl %i:f 'T~% A]"5~ %}O:j Meckel~] iI]l1. ~
~~ ~7,j%}~tt. ::L .2:j 1ill]~ t.Jl~ ra-Al {l~ -9-
%~.!jL91 *~ ~ ~%, ~~o] ~~ ~~¥l ~'T%
7]~ 91{l%}oJ] 7H*+ {lJt!¥l 78-9-~qOI 6).
Meckel~l iI]l1.~~ ~0}91 ~"'S.g. 1ill]~ ~].2:j%}.Jl
487~~ 0l%} $1..Q..uj, *.!jLllJloJ, *~ ~ *~7J73j%
91 *l2}~91 ~AJol t+E}\:! +.!jLE~ 'T~ol o]-y-~
-"17]7J}-"1 ~tr 2.3~9.l -"1~71{}01 ~~q.
~{! 7H BJAJ ~] ,AJ{}l2}~,c: 6ill]£. .5'..-¥- ~,A~ \To}
~q. 5illl~ ~,AJ9.l ~~(prolapse)ol ~~..Q..uj,
0] 'F 1ill]~ t.Jl~ tlA] lljj~~91 :±,7,j~ .!t~q.
y.o-J-"] 1ill]~ ~lt:ll ~,AJ~ %1fl'~~ ~]t:ll~l:l]7} ~
~ T~£oa~% Al"5J%}~q. 917H~ ¥l ~lt:ll%~
\To}£} 97H~ ¥l ~l% \To}oJ1Ai ~ °1:±.,A.3 ~~l2}£
73jol ~~q.
~],AJ{}l2}~ \t~ 101l~ 847n~¥l \To}£. ~,A~Al
.!f-E~ A-1Ai'8"] -"}4~ ~]t:ll%}BJoJ]A, ~-"l~~ ~~~
9-:±'£. 'T~'8"}~~ 78-9-~q. t+o-J-"l 101]~ 37H~
¥l \To}£. \t~91 ~~..Q..£. *l2}~ ~ ~..Q..3'iq.
%- 4501]9.l Meckel~] ill 11. 'F 'F.Jol-~~ 0] ~ ~ ~
2801]£} -9-~'8"] ~7,j¥l 1701]'F £73j~c.j {lA}~~
91 ~~ol 7}'o%}~~ 78-9-~ Z}Z} 2501l£} 15 ill] 0]
~q. o]:±.),J ~~l2}~6J,c: ~AJ~~O] ~~ -;roJ]A,
901](36 %), -9-'?j'8"] ~7,j~~~ -;roJ]A, 1011(7 %)
£. t+E}~q. ~.v1 °l:±.,AJ ~],AJ£6J,c: -¥- -;roJ]A, z}
Z} 101]1Q %1fl'~~ t+E}~..Q..uj, t!~..Q..£. y.E}\:!
784-~ ~~q. 9 ill] 91 ~AJ~~-;roJ1A, ~~ (n=6)
~ ,AJJlj111l (n=18)7} Z}Z} 4illl, ,AJ~~(n=4)0] 1
ill]£. y.Ej-~q.
"EIl 0}9.l ~AJ ~78'F J:jJ,A~71 29-£} 49- )..}o]oJl \:!
~'-8-0] J:jJo}91 'F,AJ9.l {l.!jLoJ] ~~~~ \:!~oJJAi
"EIl 0}£. oa 0J:~ ~i:f%}~ ~~ ~1,AJ{}l2}~014 %}uj,
o]~ "EIl1fl'0] ~,AJ~~ 'iJ~ 59-oj]).., 72f=- )..}o]oJ] ~]
Table 6. Clinical Features of Perforated Meckel's Diverticulum
No. of Sex Age Chief complaints Preop. diagnosis Gastric cases mucosa
1 M 2yr Pain, melena Ruptured MD + 2 M 2yr4m Distension Panperitonitis
3 M 2yr9m Distension, vomiting Intestinal obstruction
4 M 14yrl0m Pain, fever Appendicitis
MD:Meckel's diverticulum
- 30-
Page 5
r11-¥-.!f1 £-¥-El !Il] ~ 7} A]3}s:J oj :}.7-J ~..Q..£ ~ i;~ t}
cj ~"5"]uj 0]!4 %1(}s:Joj 'd%'"3- ~~s:. %A]oJ] ~
§j-"5"}71] ¥lcj-. APJn~ %UJl.g. AJ7-Jn~ %~.9.J UJ
Ii:!: ~7.]£ ~ ?'oJ 0] ~AR"5"}uj, uJIi:!:~7-J~ 0J1?1% 7.]
tf A~]7-Jn~~~ u:J-ct "1"i;~~cj-. O]~ 'd%'"3-0] A}
ct~ ~oJ]s:. 1fA]%'?l ~AR"5"}cj "EllA~7] 8"1"oJ] ~§j
~cj-. ~Jtl Al]7-Jn~~ ?8 ~.g. 'd%'"3-oJJAl 7] A] t}cj
"Ell O}~ ?8 UJl %..Q..£ '?j ~s:J ~J:~l. 0] ~ ;}l]7-J5q (pan
creatic bud) '3J n5q (liver bud) 7} A~ 7-J1l'oJ] u:J-ct
?8~%JI} ~C1s:jJI. ~-¥-~ {Jo]7.]7-J A~] 3~~~ AJ
tlJoJ]Al n{t~7-1]~ '?j~s:Juj "EllA~ 7 ] 27H~uJoJ] A}
ct7.]71] ¥l cj-. .:<::.%71] -'f-~ A~]7-J Zl: ~ ~ % ~ JI} ~-¥
Al]7-Jn~~ ?8~.g. ~A~~oJls:. ~%r11£ 'J0} 7-J!Ill
~~ %~"5"}711¥lcj-56. 1959\1 Soderlundl~ o]cl
~ !Il] ~ JI}?8 ~ °VJoJl u:J-ct '?l T ~ Q{ 2 % oJJAl
Al]7-Jn~~ !Ill ~71 ~ % .1i. '?l cj-JI. .li!.JI."5"}~..Q..uj, .5E
~ 01 ~~% MeckeB<l 711~, All7-Jn~~ '"3-~, ~
%r11, A~lr11%~, All%, ~{l, 7HtlJ-A~ A~l7-Jn~~~ 6
7}7.1£ ~*t}~cj-. 01 % Meckel~] 711~01 Q{ 65
%£ 7}7-J ~"5"}uj, ~%r11-i::- Q{ 11 %~ .li!.01JI. ~
{l, 7RBJ-A~ A~]7-Jn~~o] 7}7-J.:<::.{t ?;i..Q..£ ~21~
CUcj-. i'!:- '?jToJ1Al~ Meckel~l 711~0] 70 %(28
illl), ~{l, 7HtlJ-A~ All7-Jn~~ol 15 % (6illl), A~l7-J
n~~ ~~A~ AJ%r117} 15 %(6illl)~..Q..uj, ;;\\l7-Jn
~~ 'ct~JI} %%01 =r cj-g 'i?..Q..£ Q{n~ ~}ol~
.li!.°1JI. CUcj-. '?jT7.}~oJl u:J-ct cj-:}. ~}ol ~ CU..Q..tf
Meckel~] 711~.g. 4.2 %-39 %oJ1 Al ~AJ~~O] tf
q'dcj-JI. .1i.JI."5"}JI. CUcj-1.3'. i'!:- '?jToJ1 Al Meckel
~l 711~.9.J lfls:.~ 2 %~..Q..uj, 01 % ~AJ% tfq'iR
illl~ 62 %£M1 Vane%3~ 39 %.1i.cj- ~'U"cj-. 01
~ Vane%30] ,(!-B'"~ 1:l}!4 {fo] ~AJ~ ~~idol
-'f-'?j"5"1 ~z:!s:j ~ lfls:.7} ~~ A~ '?l ~7.} ~ All ~ t}
~7] u:]J{t'?l ?;i..Q..£ A~Zf¥!.cj-.
Moore7oJl ~"5"}1?1 ~AJO] id~ All7-Jn~~ 7]~
.9.J ~A~1:l]%.g. 'JL1011 Al ~cj-JI. .1i.JI.t}JI. CU..Q..tf,
~ AJO] CU ~ ~ -'f-oJ] Ai ~ 'JAoJ] Ai ~cj-JI. tm cj-.
Soderlund8s:. ~AJol CU~ ~-'f- 'JL1l:l17} 7: 1£
tfq'J~ .li!.JI.~ 1:l} CU..Q..uj, ~AJO] id~ ~-'f-011Al
~ ~~ 1:l]%£ ~z:!s:j~cj-JI. "5"mcj-. i'!:- '?jToJ1 Al
-i::- 'iPJo 1 CU ~ ~ -'f- 'Jo }oJJAl -'f-A11"5"} 711 tf q;J..Q..
uj(4.6:1), ~AJol id~ ~-'f-oJ1Als:. 'JO}7} cjo}.li!.
cj- 5:i5- ~.g. ?;i(1.7:1)..Q..£ 5:A}s:J~cj-.
Vane%3.g. A~l7-Jn~~ 7 1~.9.J %AJ..Q..£ ~~
(48), !Ill~ (28), %~(4), A~lr11~l:l] (4)'i?..Q..£ .1i.
JI.tmcj-. St- Vil%9.g. 7}7-J ~~ ~~'5'..Q..£ 7-J!Il]
~(42 %)~ .1i.JI."5"}~~J:~1. =r ~'?l..Q..£~ ~{l,
(41 %)0] 7}7-J ~'U"..Q..uj, =r!lf01l 7-J'5'-"J'5'(39 %)
JI} 7-J%:3} , *7Jt.J1 ~7-J, l:l1 ~ ~ (kinking)%Ol~..Q..
uj, =r cj-%..Q..£ ~~ ~~'5'..Q..£~ 7-J~~(38
% ), 711 ~ ~ (14 %), A~l r11 ~:}. (umbilical lesion)
(6 %)'i?..Q..£ .1i.JI.t}~cj-. Soltero'g's:. 7-J!Il1~~
7}7-J ~~ ~~'5'..Q..£ .1i.JI."5"mcj-. i'!:- '?jToJ1Al~
7-J!Il1~7} 50 %(23illl)£ 7}7-J ~~ lfls:.~ .1i.~..Q..
uj, ::J. cj-g..Q..£ A~1r11~l:l1%(10illl. 21 %), 7-J~~
(6illl, 13 %), ~..::g.(5illl. 11 %)'i?0]~cj-. =rcltf
7-J!Ill~~ ~'?l..Q..£ Meckel~] 711~01 Al~-¥-7} ¥l
;<J%~~o] 12ill1(52 %)£ ~.g. lfls:.~ ~}7.]"5"}~
cj-. 01 %l0.g. Meckel~l 711~~ ~~'5'..Q..£ ~~ol
7}7-J ~'U"..Q..uj, 711~.9.J ~..::g.JI} 7-J!Ill~.9.J 'i?..Q..£ tf
q;Jc} JI. .li!.JI."5"}~ ct.
~~% "1":}.£ t.J1~~ ~0}oJ1Al 7.}A1]~ ~~%
-",H4~ Meckel~] 71]{l~ ~~% ~1l~ Y CU~..Q.. uj, 0lcl~ ~-'f-oJ1Al 99mTc-pertechnetate "1"A}~
% 0l%"5"}cj ~li:!:oJ1 s:.%o] s:J~cj-. 0lcl~ "1"A}~
~ Sfakianakis%"ol 90 %O]AJ~ ?8~s:.~ .1i.'?l
cj-JI. .1i.JI."5"}~..Q..uj, Kusumoto%12.g. ~7.}~ ~AJ
JI} "1"A}~% o]%"5"}cj 88 %.9.J y~{l, ~t!%% .li!.
~cj-JI. ~JH}~cj-. i'!:- '?jToJ1 Al ~~~.9.J 99mTc_
pertechnetate "1"A}~ ~ 0l%~ ~t!%.g. 83 %~
cj-. Kusumoto%12.g. ~~01~.9.J ~~~.9.J ~-'f-oJl
Ai y~{l, ~t! A~..::g.~% 11 %£ .li!.JI."5"}~..Q..uj,
Llidtke%1 3.g. Meckel~l 711~.9.J y~{l, ~ 1i:!:%01
4 %£ nH-'f- ,;;!-cj-JI. "5"mcj-. °1~ Meckel~l 711{l%
~1l'~ All7-Jn~~ {}*olAJ~ ~t!oJ1 ~.g. oj21%
01 CU%% .1i.cj ~cj-. i'!:- '?jToJJAls:. ~~ ~ ;;\\] ~~
Meckel~] 711~.9.J y~{l, ~t!%.g. 4.5 %£ ~.;:-~
~-'f-!4 ~ ~}o]-i::- id~cj-.
Yamaguchi%14.g. {l, Meckel~] 711~~A}.9.J 9.1
%, Mcparland%IS.g. 10 %, St-Vil%9.g. 28 %01]
Ai O]:}.A~ .!f11l~5:~01 ~z:!s:J~cj-JI. "5"}~..Q..uj,
Leijonmarck%16.g. %AJ~~ol CU-i::- ~-'f-oJ1Al~
3~40%~~ ~z:!¥!'cj-JI. ~~JI. ~~% ~..Q..~
- 31-
Page 6
- ~o~.2.J3!~ : ~14 i'! ~11 ~ 1998\! -
12al]~ 9al]oJj)'1 O]~Ad !f1-11~5:z,j% B~15}$;tqJI.
.!2..JI. 15}$;t q. ~ ~ ToJ] Ai ~ ~ Mecke\ .;.\] 71] {J ~o}
~ 25 % C10al]) oj] Ai o]~Ad !f1-11~5:z,j% ~{!15}
$;t.2-uj, 0] ~ ~AJ~~O] ~:::: roJ]Ai 36 %(9
al]), ~'t!15] ~{!~ iCoJ]Ai 7 %C1al])£ y.Ej-);l:q. ~~ ~'€l.0] ~~lii 6al]~ 4al](67 %)oJ]Ai o]~Ad
!f1-11 ~ 5: z,j ° ] ~ {! £1 ~.2-uj , 1 all oj] Ai ?W;<;J 5: z,j 0]
%~£1~q.
~~ 7TI tlJAd A~] 7.Jz}~B~ Jtis:.~ ~Ag 15,000r;l
~ 1r;l'.2-£ E:.~ ~~.2-£ ~a:jAj ~q. ~AJ.g. t:J1
-¥-~ ~Ag' z,j4--¥-£1 y.Ej-y.y., Q.j: 40 % oj] Ai Ag4-17H!77}.:A] ;<']li.7} o]if-oj.:A].:A] ?l2. 51.2-£ ~a:jAj
~q. ~1..jjoJ]Ai:::: 1973';1 ~ % 1al]' 7~ .!2..JI.o]211
~ % 2al]18, Ai '; 1al] '9, % % 1al]2°, ~ % 1al]2l,
0] % 4al]22% ~al] .!2..JI.7} ~~q. ~~oJ]Ais:.
1990';177}.:A] % 65al]~ .!2..JI. "il 0] ~~q23. ~ ~T . .
oJ]Ai:::: ~~ 7TItlJAd ~jAJZ}~B 6al]~ 5al](83.3
%)OJ]Al §1 7.J~ 1t~0] ~~.2-uj, .£.f 17l%! u]"il
~ {lAg o}$;t q.
Mecke\.;.\] 71] {l ~ oj]l'IJ.3j 7..;jA oj] t:J1 15}e:j Sol tero
%'2. Mecke\.;.\] 71]{l ~.:A}OJ]Al IIJAg 4.2 %~ o]~
~g .!2..0]JI. Y.O]7} ~0}~9-~ :J. Jtis:.7} '7t0}~
qJI. -8l$;t.2-uj, ~A}~~ Agr;l% T15r7] !f13l1Ai~
800r;l~ ~AoJ]Ai Mecke\ .;.\] 71]{J% ~]7-13l10~ ~q
JI 15r$;tq. Ltidtke%'3.g. Mecke\.;.\] 71]{J~ ~~]4-
9-.£ ~Ag£1:::: ~~~2. 9-~4- 7.J%:3}0]uj :J. Jti
s:.:::: 8 % $;t q JI .!2..JI.15r$;t q. :J.~ ?~ 4- '7t 2. ~
~~~ Jtis:..~ .!2..o]uj %~ ~~]~ 15}.:A] ~2. 7S~
OJ] Ai y.~oJ] 11 z{~ ~t!l ~ g .!2.. ~ ? ~ q JI iir$;t
q. rr}c.]-Ai ~~~o] y.El-\! ? ~~ !f1~r'tl 2A~]
O]15r~ ~oroJ]Ai Mecke\.;.\] 71]{J~ oj]l'IJ.3j ~~]~
2. .3j g ~o] ~qJI iimq. ~~ 0] %I0.g. ~~~
~ ~AJ g y.El-1..jj:::: Mecke\.;.\] 71] {J 0] 2A~] 0] 15}oJ]
Ai 75 % g ~r.:A]ii}JI 2A~] O]AJ~ ~AoJ]Ai::::
Meckel.;.\] 71] {l OJ] ~ ~ ~ ~ ~ ~ lfls:.7 r if z:j "8"] ~
5:15}uj, ';:}0}7r 88 %0]E...£ ?~4- o]~~% JIa:j
15}~ 2A~] 0]15}~ ';:}o}oJ]Ai oj]l'IJ.3j ~A~]~% ~ ?
~.2-y., 2A~] °VJo]JI ~'tl-.3j.2-£ =; o]~ ~{!o]
~.2-~ oj]l'IJ-3cj ~A~]~ ~.B.. ~qJI 15l-$;tq. ~ 't!T
~3!}OJ] ~15l-~ Meckel.;.\] 71]{J~ ~t!l~o] 2A~] 0]
~OJ]Al 53.6 %, 4A~] o]~OJ]Al 82.2 %7r ~Ag15l-$;t
.2-uj , =;15] ~'€l.~ ~ oj]oJ]Ai 4A~] o]~oJ] ~Agiil-$;t
q. Ad~.g. 71]{J~'€l.0] 4:2£ e:jol-oJ] ~~.2-uj, 71]
{J{ii'-.g. ~ oj]oJ]Ai \l-ol-$;tq. rr}c.]-Ai 4A~] o]~~
~ 7.}oJ] Ai Ad ~ oj] Bll] ~ 0] Meckel.;.\] ll] {! ~ oj]l'IJ
.3j ~An~g A]?;~15}:::: 510] y.El-\! 9- ~:::: ~t!l~
% ~~ 9- ~% 51.2-£ Agz{~q.
1. Soderlund S : Meckel's diverticulum: A
clinical and histologic study. Acta Chir
Scand Supp\ 248:200-233, 1959
2. Migliaccio AV, Begg C: Meckel's divertic
ulum. Am J Surg 76:188-196, 1948
3. Vane DW, West KW, Grosfeld JL: Vitel
line duct anomalies: Experience with 217
childhood cases. Arch Surg 122: 542-547,
1987
4. Soltero MJ, Bill AH: The natural history
of Meckel's diverticulum and its relation
to incidental removal: A study of 202
cases of diseased Meckel's diverticulum
found in King County, Washington, over a
fifteen year period. Am J Surg 132: 168-
171, 1976
5. Amoury RA, Snyder CL : Meckel's diver
ticulum, in O'Neill, Jr JA, Rowe MI,
Grosfeld JL, Fonkalsrud EW, Coran AG
(eds) : Pediatric Surgery ( ed 5), chapter
76. Mosby-Year Book, St. Louis, Missouri,
1998, Pp 1173-1184
6. Kleinhaus S, Cohen MI, Boley SJ: Vitel
line artery and vein remnants as a cause
of intestinal obstruction. J Pediatr Surg
9:295-299, 1974
7. Moore TC: Omphalomesenteric duct mal
formation. Semin Pediatr Surg 5: 116-123,
1996
8. Soderlund S: Meckel's diverticulum: A re
port of 115 cases. Acta Chir Scand 110:
261. 1956
- 32-
Page 7
9. St-Vil D, Brandt ML, Panic S, et al:
Meckel's diverticulum in children : A 20-
year review. J Pediatr Surg 26: 1289-
1292, 1991
10. °l-"cj~, ~-9-TI-, Af~~, A,:JAcj.g., lo!{::rj-'tL ~-9-
71: ~0}cj1 Al y~% .9..~ l1lJ~711~~ <iPJ--"J-.
~0}9jJ1j-1(1):33-39, 1995
11. Sfakianakis GN, Hasse GM: Abdominal
scintigraphy for ectpic gastric mucosa: A
retrospective analysis of 143 studies. Am
J Roentgenol 138:7- 12, 1982
12. Kusumoto H, Yoshida M, Takahashi I, et
a l : Complications and diagnosis of meckel'
s diverticulum in 776 patients. Am J Surg
164: 382-383, 1992
13. Li.idke FE, Mende V, Kohler H, Lepsien
G: Incidence and frequency of complica
tions and management of Meckel's diver
ticulum. Surg Gynecol Obstet 169 :
537-542, 1989
14. Yamaguchi M, Takeuchi S, Awazu S:
Meckel's diverticulum : Investigation of 600
patients in Japanese literature. Am J Surg
136:247, 1978
15. Mcparland FA, Keisewetter WB: Meckel's
diverticulum in childhood. Surg Gynecol
Obstet 106:11-14, 1958
16. Leijonmarck CE, Sandelin KB, Frisell J,
Raf L: Meckel's diverticulum in the adult.
Br J Surg 73:146- 149, 1986
17. ~~~, 7doJ~ , ;;<J-§]l1J: 7~ tlJ--"cj A11 ;;<J-;Q~:B- 1
il11. t:Jl~9jJ1j-"§:j-~7-1 15:171-174,1973
18. ;;<J-ll1R, ~~~: A11;;<J-;Q~:B-~ 71"os. tJl~9jJ1j
"§:j-~7-1 16:755-760, 1974
19. +;g.*, .:gJa, ~~~: Down-l'l ~~.;:c-J1j- %1(} B 7~ tlJ--"cj A11 ;;<J-;Q ~:B- ~ ~;;<J- ~1 j:JJ 1 il11. tJl~
9jJ1j-"§:j-~A1 37(5):675-679, 1989
20. %yoJ : -*~ Ii}~J1j- %1(}B A11t:Jl 71"os. t:Jl~9j
J1j-"§:j-:§}7-1 39(5):703-707, 1990
21. lo!{{}iT: 7~tlJ- -"cj ~1;;<J-;Q~:B-% J8-~ ~;;<J- {j~
~~. t:Jl~9jJ1j-"§:j-:§}7-133(12): 171 3-1 717, 1990
22. 01-9-%, 0 l ~T, ~~"§:j-: 7HtlJ--"cj A11 ;;<J-;Q~:B- 71 "OS4oj1 .!2...:il. ~0}9jJ1j-3(2): 148- 151,1997
23. Yamata T, Seiki Y, Yoshikawa T: Patent
omphalomesenteric duct: A case report
and review of Japanese literature. Asia
Ocean J Obstet Gynecol 15: 229- 236, 1989
- 33-
