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Meckel's Diverticulum in Children-Parameters Predicting the Presence of Gastric Heterotopia
Ivana Slívová1,2, Zuzana Vávrová1,2, Hana Tomášková3
1Department of Surgery, University Hospital Ostrava, 17. listopadu 1790, 708 52, Ostrava, Czech Republic.
Insights
Gastric heterotopia in Meckel's diverticulum is linked to complications. A wider diverticulum base is a key predictor, suggesting surgical resection for asymptomatic cases with this feature.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Pathology
- Surgical Oncology
Background:
- Gastric ectopic mucosa in Meckel's diverticulum increases complication risk.
- Identifying predictors of gastric heterotopia is crucial for patient management.
- This study focuses on pediatric cases to understand these associations.
Purpose of the Study:
- To determine demographic and clinical factors predicting gastric heterotopia in pediatric Meckel's diverticulum.
- To identify potential indicators for increased risk of complications.
- To inform surgical decision-making for asymptomatic Meckel's diverticulum.
Main Methods:
- Retrospective cohort study of 88 pediatric patients undergoing Meckel's diverticulum resection.
- Analysis of demographic data, clinical parameters, and surgical details.
- Histopathological examination to confirm gastric heterotopia and assess resection margins.
Main Results:
- Gastric heterotopia was found in 44.3% of pediatric patients.
- No correlation observed between heterotopia and age, gender, birth weight, or diverticulum length.
- A significantly wider diverticulum base (p < 0.001) was strongly associated with gastric heterotopia.
Conclusions:
- The width of the Meckel's diverticulum base is a significant predictor of gastric heterotopia.
- Surgical resection of asymptomatic Meckel's diverticulum with a wide base is recommended.
- This finding aids in risk stratification and surgical planning for pediatric patients.
Background:
The presence of gastric ectopic mucosa in Meckel's diverticulum is associated with a higher risk of development of complications. The aim of the present study was to investigate which demographic/clinical parameters predict the presence of gastric heterotopia in Meckel's diverticulum.
Methods:
This was a retrospective cohort study conducted in a single institution (University Hospital Ostrava, Czech republic). All children who underwent laparoscopic/open resection of Meckel's diverticulum within a 20-year study period were included in the study.
Results:
In total, 88 pediatric patients underwent analysis. The mean age of the children was 4.6 ± 4.73 years; the male-female ratio was approximately 2:1. There were 50 (56.8%) patients with asymptomatic Meckel's diverticulum in our study group. Laparoscopic resection was performed in 24 (27.3%) patients; segmental bowel resection through laparotomy was performed in 13 (14.8%) patients. Gastric heterotopia was found in 39 (44.3%) patients; resection margins of all patients were clear of gastric heterotopia. No correlation was found between the presence of gastric heterotopia and the following parameters: age, gender, maternal age, prematurity, low birth weight, perinatal asphyxia, distance from Bauhin's valve and length of Meckel's diverticulum. The width of the diverticulum base was significantly higher in patients with gastric heterotopia (2.1 ± 0.57 vs. 1.2 ± 0.41 cm; p < 0.001).
Conclusions:
According to the study outcomes, the width of the diverticulum base seems to be a significant predictive factor associated with the presence of gastric heterotopia in Meckel's diverticulum. The laparoscopic/open resection of asymptomatic MD with a wide base should therefore be recommended.