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[Meckel's diverticulum in children]
Insights
This study reviews 92 pediatric surgeries for Meckel
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Congenital Anomalies
Context:
- Meckel's diverticulum is a common congenital anomaly of the small intestine.
- It can lead to various complications requiring surgical intervention in children.
- This retrospective study analyzes surgical cases over a decade.
Purpose:
- To analyze the surgical management and outcomes of pediatric Meckel's diverticulum.
- To correlate clinical presentations with specific pathological findings.
- To evaluate different surgical approaches and techniques used.
Summary:
- Operations were performed on 92 children with Meckel's diverticulum complications including diverticulitis, intussusception, and hemorrhage.
- Clinical presentations varied, often mimicking other acute abdominal conditions like appendicitis.
- Surgical approaches included laparotomy and various diverticulectomy or resection techniques.
Impact:
- Provides insights into the diverse clinical spectrum of Meckel's diverticulum in children.
- Highlights diagnostic challenges and the importance of considering Meckel's diverticulum in pediatric surgical emergencies.
- Offers data on surgical techniques and their application in managing this condition.
Abstract:
In 1978-1988 operations were performed on 92 children: 35 with diverticulitis, 7 with intestinal intussusception, 5 with hemorrhage from an ulcer of the diverticulum, 13 with strangulation or mechanical ileus, 2 with strangulated Littre's hernia, one with torsion of the omentum, 22 with secondary diverticulitis, and in 7 children Meckel's diverticulum was a chance finding during other operations in the cavities. Boys accounted for 60.9' (56) of cases. There were 12 children under one year of age, nine from 1 to 3 years, 17 from 3 to 5 years, 17 from 5 to 7 years, and 12 children aged from 7 to 10 years. The clinical manifestations depended on the pathological changes developing in Meckel's diverticulum. A clinical picture of acute appendicitis developed in diverticulitis, six children had a typical picture of intussusception, and one child had a picture of acute abdomen. Anemia and a stool with dark blood were encountered in hemorrhage from a diverticular ulcer. Seven out of 13 children with ileus had a pronounced clinical picture, in the remaining 5 it was unclear and resembled that of acute appendicitis. Meckel's diverticulum was suspected before the operation in 17 (9.95%) patients. The Volkovich-Dyakonov laparotomy approach was used in 64 children, a pararectal incision in 9, a transrectal incision in 15, a median incision in one patient, hernio-laparotomy was conducted in one and Shpizi's operation in 2 children. Diverticulectomy was accomplished by the oblique-transverse method in 79 children, by the wedge techniques in 5, by the purse-string method in 2 patients, and resection of the intestine with the diverticulum was conducted in 5 children.(ABSTRACT TRUNCATED AT 250 WORDS)
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