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Reevaluating the rule of two's: Age and epidemiological variations in Meckel's diverticulum
Ashley Polachek1,2, Megha S Mehta1,2, Ahmed Shalaby3
1Division of Pediatric Gastroenterology, UT Southwestern Medical Center, Dallas, Texas, USA.
Journal of Pediatric Gastroenterology and Nutrition
|July 23, 2026
Summary
Over half of pediatric Meckel's diverticulum (MD) cases are diagnosed after age five. Clinical presentation and diagnostic imaging for MD significantly vary by patient age.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Diagnostics
Background:
- Meckel's diverticulum (MD) is a congenital anomaly of the small intestine.
- Delayed diagnosis of MD can lead to complications such as obstruction, intussusception, or bleeding.
Purpose of the Study:
- To analyze the clinical characteristics and diagnostic approaches for Meckel's diverticulum (MD) in pediatric patients.
- To investigate age-related variations in the presentation and diagnosis of MD.
Main Methods:
- Utilized the Kids' Inpatient Database (KID) for 2016 and 2019 to identify pediatric patients with MD.
- Conducted a retrospective review of 147 patients diagnosed with MD at a single institution over 20 years.
- Confirmed diagnoses through surgical findings and pathological examination.
Main Results:
- Over 60% of pediatric patients in both datasets were diagnosed with MD after the age of five.
- Younger children (≤5 years) more frequently presented with painless rectal bleeding and underwent Meckel's scintigraphy.
- Older children (>5 years) were more likely to exhibit abdominal pain or vomiting and undergo CT scans, with longer hospital stays observed in younger age groups.
Conclusions:
- A significant proportion of pediatric Meckel's diverticulum (MD) cases are diagnosed later in childhood.
- Age-specific clinical presentations and diagnostic imaging preferences are evident in pediatric MD cases.
- Diagnostic strategies for MD should consider age-related variations in symptoms and imaging findings.
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