Meckel's diverticulum in children, clinical and pathological aspects

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Congenital Malformations

Background:

• Meckel's diverticulum (MD) is a common congenital malformation of the digestive tract, resulting from the incomplete obliteration of the omphalomesenteric duct.
• While 2-4% of the population carries MD, most cases remain asymptomatic (AS MD), often discovered incidentally during surgery.
• Symptomatic MD (S MD) can present with diverse, non-specific pathologies mimicking other gastrointestinal conditions, requiring careful diagnosis.

Purpose of the Study:

• To analyze the clinical presentation and outcomes of symptomatic and asymptomatic Meckel's diverticulum in pediatric patients.
• To differentiate the common causes of MD-related symptoms and incidental findings in children.
• To provide insights into the age distribution and surgical management of MD in a pediatric cohort.

Main Methods:

• Retrospective analysis of 44 pediatric patients (0-16 years) diagnosed with Meckel's diverticulum.
• Categorization of patients into symptomatic (S MD) and asymptomatic (AS MD) groups.
• Review of clinical data, including presenting symptoms, surgical interventions, and diagnostic findings.

Main Results:

• Of 44 children, 29 had S MD and 15 had AS MD.
• S MD cases commonly presented with intestinal obstruction (14), lower gastrointestinal bleeding (7), diverticulitis (5), and peritonitis (3).
• AS MD cases were incidentally found during surgery for acute appendicitis (14) or inguinal hernia (1).

Conclusions:

• Meckel's diverticulum frequently presents asymptomatically in children, often discovered during surgery for other conditions like appendicitis.
• Symptomatic Meckel's diverticulum in children can manifest as serious complications including obstruction, bleeding, inflammation, and peritonitis.
• Early recognition and appropriate management of Meckel's diverticulum are crucial for preventing severe pediatric gastrointestinal complications.