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Meckel's diverticulum in children: Our 12-year experience
Kamal Nain Rattan1, Jasbir Singh2, Poonam Dalal2
1Department of Pediatric Surgery, PGIMS, Rohtak, Haryana, India.
Background:
Meckel's diverticulum (MD) is the one of the most common congenital malformation of gastrointestinal tract and has varied clinical presentations. We are presenting here our 12-year experiences with MD in children at tertiary care hospital in North India. It highlights the fact that isolated gangrene of MD can occur, and it is associated with increased morbidity.
Materials And Methods:
This retrospective study is conducted by analysing the medical records of the patients who were operated for MD in the last 12 years in paediatric surgery department at our hospital.
Results:
Sixty-five patients were operated for MD in study period; in this 52 were males and 13 were females with mean age of presentation 3.2 years. The most common presentation was intestinal obstruction seen in 86.1% (56 cases). Intestinal haemorrhage was seen in 4.6% (3 cases) and diverticulitis in 3% (2 cases). Perforation of the gut with peritonitis was present in 6.1% (four cases). Cause of obstruction was intussusception in 21.4% (12 cases), fibrous band connected to umbilicus in 17.8% (10 cases), volvulus in 17.8% (10 cases), kinking in 16.0% (9 cases), knotting in 14.2% (8 cases) and herniation of gut below in 12.5% (7 cases). Isolated gangrene of MD was present in ten cases with intestinal obstruction. The ectopic gastric mucosa was seen in three and pancreatic mucosa in two cases. Mortality and morbidity during the study were one and three cases, respectively.
Conclusion:
MD may remain clinically silent for lifetime, or it may have life-threatening complications. In our series, intestinal obstruction and not the haemorrhage was the most common presentation. Isolated gangrene of MD with obstruction was present in significant numbers, which we failed to find in literature.
Insights
Meckel's diverticulum (MD) in children often presents as intestinal obstruction, sometimes with isolated gangrene, leading to increased morbidity. This 12-year study highlights these critical findings in North India.
Area of Science:
- Pediatric Surgery
- Congenital Malformations
- Gastrointestinal Disorders
Background:
- Meckel's diverticulum (MD) is a common congenital gastrointestinal malformation with diverse clinical presentations.
- This study reviews 12 years of pediatric Meckel's diverticulum cases at a tertiary care hospital in North India.
- Highlights the occurrence of isolated gangrene of MD, associated with increased morbidity.
Purpose of the Study:
- To analyze the clinical presentations and outcomes of Meckel's diverticulum in children.
- To investigate the incidence of isolated gangrene of MD and its impact on morbidity.
- To contribute data from North India to the existing literature on pediatric Meckel's diverticulum.
Main Methods:
- Retrospective analysis of medical records of pediatric patients operated for Meckel's diverticulum over 12 years.
- Data collection included patient demographics, clinical presentation, surgical findings, and outcomes.
- Focus on identifying common presentations, complications like isolated gangrene, and associated morbidities.
Main Results:
- Sixty-five patients (52 males, 13 females; mean age 3.2 years) were operated for MD.
- Intestinal obstruction was the most common presentation (86.1%), followed by hemorrhage (4.6%) and diverticulitis (3%).
- Isolated gangrene of MD occurred in 10 cases, often associated with intestinal obstruction; mortality was 1.5% and morbidity 4.6%.
Conclusions:
- Meckel's diverticulum can present asymptomatically or with life-threatening complications.
- Intestinal obstruction is a more frequent presentation than hemorrhage in pediatric MD.
- Isolated gangrene of MD with obstruction is a significant finding not commonly reported in literature.
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