The damages of processus vermicularis and Meckel’s diverticulum in gun–shoot abdominal woundings

Abstract

Objective. Determination of the damages peculiarities in processus vermicularis and Meckel’s diverticulum in a gun–shot abdominal woundings and tactics of their surgical treatment. Materials and methods. Analysis of the gun–shot abdominal woundings has been witnessed the presence of isolated and combined damages of processus vermicularis and Meckel’s diverticulum in 0.18 and 0.06% patients, accordingly. All the wounded persons were the men, their average age have constituted (32±0.3) yrs old. The shrapnel woundings have occurred in 92.4% patients, and the bullet – in 7.6%. Damages of the processus vermicularis base have dominated in its descendent localization, the damages of processus vermicularis and Meckel’s diverticulum were combined with such intestinal affections. Results. All the damages of Meckel’s diverticulum and processus vermicularis were revealed intraoperatively. All the hospitalized patients have had the pain syndrome, the peritonitis signs and free liquid in a small pelvis. Surgical tactics consisted of resection of processus vermicularis (in 2 patients using laparoscopic approach), and in the Meckel’s diverticulum woundings the operative intervention volume have included a wedge–like resection of the small intestine part with diverticulum or segmental intestinal resection with formation of the side to side ileo–ileoanastomosis. Conclusion. The damages of processus vermicularis and Meckel’s diverticulum constitute a rare combat woundings, which occurs in combined intestinal trauma, what constitute the need for its detailed intraoperative revision. Operative tactics in damages of processus vermicularis and Meckel’s diverticulum constitutes their resection and restoration of intestinal integrity and may be realized through laparoscopic access.