Meckel's diverticulum: differences in clinical features between children and adults

The objectives were to describe and to compare the clinical features of patients with MD in terms of demographic data, clinical presentation, investigations, treatment, histopathology, and postoperative complications between children and adults.

Patients with MD were retrospectively reviewed from two tertiary hospitals (2002-2021). These included patients with symptomatic MD and patients whose MD was incidentally found during operations. Demographic data, clinical presentation, investigation, treatment, histopathology, and postoperative complications were reviewed.

A total of 123 cases with MD (69 children vs 54 adults) were studied. Of 69 children with MD, symptomatic MD was reported in 48 cases (69.6%). Lower GI bleeding was the most common presentation (52.1%), followed by obstruction (29.1%), umbilical problems (10.4%), and diverticulitis (8.3%). For children with bleeding MD (25 cases), Meckel scan was an important investigation to confirm the diagnosis, with a sensitivity value of 95%. Of 54 adults with MD, symptomatic MD was recorded in 30 cases (55.6%). Diverticulitis was the most common presentation (46.7%), followed by obstruction (30.0%), GI bleeding (20.0%), and umbilical problems (3.3%). For incidentally found MD during operations, 80% were resected. Interestingly, ectopic gastric tissue was found in 27.4% of the resected MD specimens. Moreover, there was no significant difference in postoperative complications between patients with symptomatic MD and patients with incidentally found MD.

The most common symptom of MD was lower GI bleeding in children, and diverticulitis in adults. Meckel scan is an important tool to investigate bleeding MD. Since ectopic gastric tissue was found in 19% of asymptomatic MD, our findings seem to support the concept of resection of MD incidentally found during the operations.