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Multimodality Diagnosis of Mesenteric Ischemia
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Clinical diagnostic predictive score for Meckel diverticulum.

Catalina Jaramillo1, M Kyle Jensen1, Amber McClain1

  • 1Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Utah School of Medicine, 81 N. Mario Capecchi Drive, Salt Lake City, UT 84113, USA.

Journal of Pediatric Surgery
|January 10, 2021
PubMed
Summary
This summary is machine-generated.

A new scoring system helps diagnose bleeding Meckel diverticulum (MD) in children. This tool can reduce the need for invasive tests like endoscopy, leading to earlier surgical intervention for pediatric patients with MD.

Keywords:
AnemiaHematocheziaMeckel diverticulumMeckel scan

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Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Diagnostic Imaging

Background:

  • Meckel diverticulum (MD) affects 2% of the population.
  • Diagnosis often relies on technetium-99m pertechnetate scintigraphy.
  • Negative scintigraphy can lead to delayed treatment due to further invasive procedures.

Purpose of the Study:

  • To identify key features of bleeding Meckel diverticulum.
  • To develop a risk score for diagnosing bleeding MD.
  • To reduce unnecessary diagnostic testing and facilitate earlier surgical management.

Main Methods:

  • Retrospective review of patients under 18 with hematochezia (2005-2015).
  • Meckel diverticulum diagnosis confirmed by histopathology.
  • Development of a points-based risk score.

Main Results:

  • 42 cases of Meckel diverticulum identified among 215 patients with hematochezia.
  • Predictive factors for MD include infant/toddler age, short duration of symptoms, large blood volume, low hemoglobin, and transfusion needs.
  • A risk score of 6 or higher strongly suggests Meckel diverticulum.

Conclusions:

  • A novel scoring system accurately identifies children with bleeding MD.
  • This score can guide decisions for exploratory surgery, potentially avoiding endoscopy.
  • The system aims to improve diagnostic accuracy, decrease unnecessary tests, and enable prompt surgical treatment.