Related Experiment Videos
[Meckel's diverticulum in childhood. Personal experience and actualization]
J M Valoria Villamartín1, E M Digiuni Avalis, G Pérez Tejerizo
1Servicio Cirugía Pediátrica, Clínica Nuestra Señora de la Concepción, Fundación Jiménez Díaz, Facultad de Medicina, Universidad Autónoma de Madrid.
Insights
Meckel
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Congenital Anomalies
Context:
- Meckel's diverticulum is a common congenital anomaly of the small intestine.
- Diagnosis can be challenging, often incidental during surgery.
- Pediatric presentations vary, including intussusception, perforation, hemorrhage, and umbilical issues.
Purpose:
- To analyze the clinical presentation, diagnosis, and management of Meckel's diverticulum in pediatric patients.
- To evaluate the utility of technetium-99m abdominal scintigraphy in diagnosing symptomatic Meckel's diverticulum.
- To review histopathological findings and surgical outcomes.
Summary:
- This study reviewed 40 pediatric cases of Meckel's diverticulum, with 77.5% found incidentally.
- Symptomatic cases (22.5%) included intussusception, perforation, hemorrhage, and obstruction.
- Technetium-99m scans had a 28.5% positive diagnosis rate in symptomatic patients. Surgical resection was performed, with ectopic gastric mucosa found in 22.5% of cases.
- Histopathology confirmed ectopic gastric mucosa in 22.5% and pancreatic tissue in one case.
- The primary morbidity was a single instance of postoperative intestinal obstruction; mortality was zero.
Impact:
- Highlights the high rate of incidental diagnosis in pediatric Meckel's diverticulum.
- Underscores the varied and sometimes severe presentations of symptomatic Meckel's diverticulum in children.
- Provides data on the diagnostic yield of radionuclide scanning and surgical outcomes, informing clinical practice and management strategies for this condition.
Abstract:
The authors present 40 cases of Meckel's diverticulum in pediatric patients (average age 6.8 years old). 31 of these (77.5%) were discovered casually in surgery and the other nine (22.5%) presented specific symptoms (three intestinal intussusceptions, three perforations, one hemorrhage, a wet umbilicus and an intestinal obstruction). In this group, seven abdominal radionuclide scan were practiced with 99mTc, resulting in two positive diagnosis (28.5%). All patients were treated with short ileal resection. The histopathological study revealed in nine cases (22.5%) the presence of gastric ectopic mucosa and, in one of them, pancreatic tissue was also found. The only morbidity was a postoperative intestinal obstruction that occurred several months later and that required surgery. The mortality was zero and the average hospital stay was 8.6 days.