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Meckel's diverticulum in the pediatric surgical population
Insights
Meckel's diverticulum, a common congenital anomaly, often presents with bleeding or obstruction in children. Surgical resection is safe and effective, with no reported complications or deaths in this study.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Congenital Anomalies
Background:
- Meckel's diverticulum is the most frequent congenital abnormality of the gastrointestinal tract.
- It can lead to various clinical manifestations in children.
Purpose of the Study:
- To review the clinical experience with Meckel's diverticulum in pediatric patients.
- To analyze the presentation, diagnosis, and outcomes of surgical management.
Main Methods:
- Retrospective review of 31 pediatric cases of Meckel's diverticulum treated between 1966 and 1987.
- Analysis of clinical presentations, diagnostic methods (including technetium scan), and surgical outcomes.
Main Results:
- Twenty-four patients had symptomatic Meckel's diverticulum, with bleeding (10 cases) and obstruction (10 cases) being most common.
- Ectopic gastric mucosa was present in all bleeding cases. Obstruction was due to internal hernia or intussusception.
- Technetium scan identified Meckel's diverticulum in 6 out of 7 cases. Diverticulitis mimicked appendicitis.
Conclusions:
- Meckel's diverticulum presents with diverse clinical symptoms in children, including bleeding, obstruction, and diverticulitis.
- Surgical resection of Meckel's diverticulum in children is associated with excellent outcomes, with no complications or mortality observed.
Abstract:
Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract. We reviewed our experience with 31 cases of Meckel's diverticulum in children from 1966 to 1987. Twenty-four patients presented with clinical manifestations: ten from bleeding, ten from obstruction, and four from diverticulitis. Seven Meckel's were incidental findings at laparotomy. Fifty percent of the patients with bleeding had abdominal pain and 100% had ectopic gastric mucosa in the Meckel's. In six cases the technetium scan identified the Meckel's; there was one false negative scan. Obstruction secondary to a Meckel's diverticulum was due to an internal hernia in five and to intussusception in five. Three patients with intussusception had concomitant bleeding. Diverticulitis was clinically similar to appendicitis. There were no complications and no deaths following surgical resection of Meckel's diverticulum.