Clinical analysis of 116 children with Meckel’s diverticulum and review of the literature

Abstract

Abstract Objective: We aimed to retrospectively analyze the clinical characteristics of pediatric Meckel’s diverticulum to improve the understanding and diagnosis of Meckel’s diverticulum in children. Methods: The clinical data of 116 hospitalized children with Meckel’s diverticulum diagnosed by surgery in the Department of Pediatric Surgery, Children’s Hospital of Soochow University, between January 2017 and January 2023 were analyzed retrospectively. Results: A total of 95 boys and 21 girls were included in this study, with a male-to-female ratio of 4.524:1. The observed clinical manifestations could be roughly divided into the following three categories: gastrointestinal bleeding in 68 cases (59%), intestinal obstruction in 35 cases (30%), and abdominal inflammation in 10 cases (9%). The positive rate of 99mTc-pertechnetate dynamic imaging (99TcmO4-ECT) was higher than that of abdominal ultrasound in all patients and patients with gastrointestinal bleeding. The sensitivity and specificity of 99TcmO4-ECT were 98% and 25%, respectively. The surgical methods of Meckel’s diverticulum are mainly divided into two types: either wedge resection of the diverticulum or resection of the diverticulum and adjacent bowel after laparoscopic or open exploration. The average distance between the diverticulum and ileocecal junction was 50.5 ± 18.2 cm, the average length of the diverticulum was 3.25 ± 1.6 cm, and the average width of the diverticulum was 1.52 ± 0.7 cm. According to the pathological examination results, the incidence of ectopic mucosal tissue in Meckel’s diverticulum in the gastrointestinal bleeding group was higher than that in the non-gastrointestinal bleeding group. The clinical symptoms of gastrointestinal bleeding in children with Meckel’s diverticulum are related to the presence of ectopic mucosal tissue. Conclusions: Gastrointestinal bleeding is the most common clinical manifestation of Meckel’s diverticulum in children, and it is closely related to the presence of ectopic mucosal tissue. 99TcmO4-ECT is an important imaging examination for the diagnosis of Meckel’s diverticulum. Once Meckel’s diverticulum is suspected, immediate surgical resection is advocated.