Male predominance in Meckel's diverticulum: A hyperacidity hypotheses

Area of Science:

• Gastroenterology
• Pediatric Surgery
• Surgical Pathology

Background:

• Meckel's diverticulum (MD) presentation varies with age, sex, and ectopic gastric tissue.
• Symptomatic MD shows a male predominance (2:1 to 5:1 ratio), unlike asymptomatic MD.
• Ectopic gastric mucosa in MD increases the likelihood of symptomatic presentation.

Purpose of the Study:

• To investigate the hypothesis that higher gastrin and acid levels in males contribute to increased symptomatic Meckel's diverticulum.
• To explore the parallels between Meckel's diverticulum complications and peptic ulcers in relation to sex-based hormonal differences.

Main Methods:

• Comparative analysis of symptomatic Meckel's diverticulum prevalence in males and females.
• Review of existing literature on acid and gastrin secretion differences between sexes and across age groups.
• Examination of Meckel's diverticulum complications (e.g., ulcers, bleeding) and comparison with peptic ulcer disease.

Main Results:

• Male infants exhibit higher acid secretion than female infants; adult males have higher acid production than females.
• Peptic ulcers, common in males due to high acid secretion, share similar male-to-female ratios (2:1 to 5:1) with symptomatic MD.
• Both Meckel's diverticulum and peptic ulcers are influenced by gastrin and acid secretion, with symptoms declining with age.

Conclusions:

• Higher gastrin and acid levels in males likely exacerbate ectopic gastric mucosa in Meckel's diverticulum, leading to increased symptoms.
• The findings suggest a hormonal basis for the male predominance observed in symptomatic Meckel's diverticulum cases.
• Further research into gastrin and acid's role could inform targeted prevention or treatment strategies for Meckel's diverticulum.