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Meckel's diverticulum in adults: seldom suspected and frequently found
Chance S Friesen1, Thomas Mario Attard2, Maria Cole3
1Gastroenterology, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, USA.
Abstract:
Meckel's diverticulum (MD) is a well-defined diagnosis in children presenting with either bleeding or obstruction. Although anecdotally adult patients may present with complications from MD, their presentation seems to be different, with a reported predominance of non-bleed-related presentations. Reports in this population, however, are limited, and little is known of the epidemiology of MD in older patients. We performed a retrospective analysis of the Agency of Healthcare Research and Quality National Inpatient Sample of all US hospital discharges from 2012 to 2016. We identified patients with a primary discharge diagnosis of MD. Data were abstracted as raw numbers and population weighted rates of discharge with age group, income level, length of stay (LOS) and hospital charges as additional information. On average, 2030 individuals were discharged annually; most (71.1%) were adults (>18 years). Although MD was predominant in males in all age groups, the gender ratio decreased with older age categories from 3.5:1.0 (1-17 years) to 1.6:1.0 (65-84 years). LOS averaged 5.3 days with no clear relationship to other parameters. Median income category, however, closely correlated (R2=0.9996) with diagnosis in older age categories. MD may be significantly more prevalent in adult patients than was previously understood. Differences in gender preponderance suggest that gender may influence the pattern of presentation. Diagnosis in older individuals is closely associated with income or socioeconomic status but not hospital charges or LOS.
Insights
Meckel's diverticulum (MD) is more common in adults than previously thought, with presentations varying by age and gender. Diagnosis in older adults is linked to socioeconomic status, not hospital stay or charges.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Epidemiology
Background:
- Meckel's diverticulum (MD) is a known pediatric diagnosis, typically presenting with bleeding or obstruction.
- Adult presentations of MD complications are anecdotally reported but poorly understood.
- Limited data exists on the epidemiology of MD in older adult populations.
Purpose of the Study:
- To investigate the prevalence and epidemiological characteristics of Meckel's diverticulum in adult patients.
- To explore differences in MD presentation and diagnosis based on age, gender, and socioeconomic factors.
Main Methods:
- Retrospective analysis of US hospital discharge data from 2012-2016 (Agency of Healthcare Research and Quality National Inpatient Sample).
- Identification of patients with a primary diagnosis of Meckel's diverticulum.
- Abstraction of data including age, gender, income level, length of stay (LOS), and hospital charges.
Main Results:
- An average of 2030 individuals were discharged annually with MD, with 71.1% being adults (>18 years).
- Male predominance was observed across all age groups, but the gender ratio decreased with age (3.5:1 in children to 1.6:1 in older adults).
- Median income strongly correlated with MD diagnosis in older adults (R²=0.9996), while LOS and hospital charges showed no clear relationship.
Conclusions:
- Meckel's diverticulum appears significantly more prevalent in adult patients than previously recognized.
- Gender may influence the pattern of MD presentation, with a less pronounced male predominance in older individuals.
- Socioeconomic status is closely associated with MD diagnosis in older adults, unlike hospital charges or length of stay.
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