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

Area of Science:

• Gastroenterology
• Pediatric Surgery
• Surgical Pathology

Background:

• Meckel's diverticulum (MD) is a congenital anomaly of the small intestine.
• Clinical presentations and management strategies for MD can vary significantly between pediatric and adult populations.
• Understanding these differences is crucial for optimizing patient outcomes.

Purpose of the Study:

• To describe and compare the clinical features of Meckel's diverticulum (MD).
• To analyze demographic data, clinical presentation, investigations, treatment, histopathology, and postoperative complications in children versus adults with MD.

Main Methods:

• Retrospective review of 123 patients diagnosed with Meckel's diverticulum (MD) between 2002 and 2021.
• Data collected included demographics, clinical presentation, diagnostic investigations, treatment modalities, histopathological findings, and postoperative complications.
• Comparison of findings between pediatric and adult patient cohorts.

Main Results:

• Lower gastrointestinal (GI) bleeding was the most common presentation in children (52.1%), whereas diverticulitis was most frequent in adults (46.7%).
• Meckel scan demonstrated high sensitivity (95%) for diagnosing bleeding MD in children.
• Ectopic gastric tissue was found in 27.4% of resected MD specimens, and no significant difference in postoperative complications was observed between symptomatic and incidentally found MD.

Conclusions:

• The primary clinical manifestation of Meckel's diverticulum (MD) differs between children (lower GI bleeding) and adults (diverticulitis).
• Meckel scan is a valuable diagnostic tool for bleeding MD.
• The presence of ectopic gastric tissue in a significant proportion of asymptomatic MD cases supports the prophylactic resection of incidentally discovered MD.