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Published on: July 12, 2018
[Meckel's diverticulum. Study of 61 cases]
F E Zárate Mondragón1, J A Ramírez Mayans, R Cervantes Bustamante
1Servicio de Gastroenterología y Nutrición Pediátrica, Instituto Nacional de Pediatría, México, D.F.
Insights
Meckel's diverticulum is a serious pediatric emergency. Rectal bleeding in infants and intestinal obstruction in older children require prompt diagnosis, with 99mTc-pertechnetate scanning being the most effective method.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Diagnostic Imaging
Context:
- Meckel's diverticulum is a congenital anomaly frequently presenting in childhood.
- Common clinical manifestations include rectal bleeding and intestinal obstruction.
Purpose:
- To determine the incidence, clinical features, complications, and diagnostic methods for Meckel's diverticulum in Mexican children.
- To evaluate the efficacy of 99mTc-pertechnetate scanning in diagnosis.
Summary:
- A 10-year study of 61 Mexican children revealed distinct presentations: rectal bleeding in infants and intestinal occlusion in older children.
- Histology showed gastric mucosa associated with bleeding and ileal mucosa with obstruction.
- 99mTc-pertechnetate scanning, particularly with H2 blocking agents, proved to be the optimal diagnostic tool.
Impact:
- Highlights the critical need to consider Meckel's diverticulum in pediatric emergencies.
- Emphasizes the diagnostic superiority of 99mTc-pertechnetate scanning for timely intervention.
- Provides population-specific data on Meckel's diverticulum in Mexican children.
Background:
Meckel's diverticulum is a well known disease in children. The main clinical presentations are rectal bleeding and intestinal occlusion.
Objective:
To investigate the frequency, main clinical symptoms, signs, complications, localization, histology and diagnosis in a population of mexican children.
Method:
We studied 61 children who were seen at the Instituto Nacional de Pediatria, Mexico City, during a period of 10 years. The age, sex, symptoms, complications, hematocrit, 99mTc-Pertechnetate scanning, histology, and localization of Meckel's diverticulum were analyzed in all of them.
Results:
15 children were female and 46 male (1:3). In infants the main clinical finding was rectal bleeding. Intestinal occlusion was the most common clinical expression in older children. Gastric mucosa was a common finding in the diverticulum of children with rectal bleeding in contrast to ileal mucosa in children with intestinal occlusion. 99mTc-pertechnetate scanning with previous administration of H2 blocking agent was the best diagnostic procedure.
Conclusions:
Meckel's diverticulum must be considered an emergency in children. Meckel's diverticulum, has to be ruled cut as in infants with significant bleeding, as well as in children with intestinal occlusion. The best method for diagnosis is 99mTc-pertechnetate scanning.
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