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Correlation of gastric heterotopia and Meckel's diverticular bleeding in children: a unique association

A Bandi1, Y W Tan, T Tsang

  • 1Department of Paediatric Surgery, Level 3, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK, ashwath@doctors.org.uk.

Pediatric Surgery International
|December 17, 2013
PubMed

Insights

Gastric heterotopia (GH) in Meckel's diverticulum (MD) significantly increases the risk of gastrointestinal bleeding in children. This finding highlights GH-positive MD as a distinct entity requiring specific management considerations.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Pathology

Background:

  • Meckel's diverticular bleeding is a common cause of major gastrointestinal hemorrhage in children.
  • Gastric heterotopia (GH) is a congenital anomaly that can occur within Meckel's diverticulum (MD).

Purpose of the Study:

  • To investigate the association between gastric heterotopia (GH) and the risk of bleeding in pediatric patients with Meckel's diverticulum (MD).
  • To determine if the presence of GH influences the initial management of Meckel's diverticular bleeding.

Main Methods:

  • Retrospective review of pediatric patients diagnosed with Meckel's diverticulum (MD) between 1995 and 2011.
  • Histological analysis to identify the presence (GH+) or absence (GH-) of gastric heterotopia.
  • Statistical analysis using Chi-square and Fisher's exact tests to correlate GH with bleeding events.

Main Results:

  • Eighteen out of 39 patients experienced gastrointestinal bleeding.
  • GI bleeding was significantly more common in patients with GH+ (67%) compared to GH- (27%) (p=0.02).
  • All bleeding in GH- patients originated from sources other than the MD; GH+ was associated with 100% of positive Meckel's scans.

Conclusions:

  • Gastric heterotopia-positive Meckel's diverticulum is a distinct clinical entity.
  • The presence of GH in MD is strongly associated with significant gastrointestinal bleeding in pediatric patients.
  • These findings suggest that the identification of GH impacts the diagnostic and management strategies for pediatric GI hemorrhage.
Abstract

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