Author:
Yan Ling,Zhou Bi,Wu Peng,Tian You,Lou Yi
Abstract
Abstract
Background
The aims of this study were to summarize the clinical presentation and histological results of 20 cases of complicated Meckel diverticulum (MD) who were presumed to have acute appendicitis before surgery, as well as to improve the diagnosis and treatment of complicated MD in children.
Materials and methods
We retrospectively reviewed the records of 20 complicated MD admitted to our institution who were preoperatively diagnosed with acute appendicitis from January 2012 to January 2019. Patients were divided into the perforated MD group and the Meckel’s diverticulitis group. Patient demographics, clinical manifestations, laboratory data, auxiliary examinations, surgical methods, and the result of heterotopic tissue were recorded.
Results
A total of 20 cases of complicated MD (perforated or diverticulitis) were identified. Children were aged from 3 to 13 years, with a mean age of 7.75 years (median 7.75; range, 1–13 years). Perforated Meckel’s diverticulum occurred in 5 of 20 (25%) cases. For perforated MD versus diverticulitis, no significant differences were found between age, time to intervention, length of hospital stay, and distance from the ileo-cecal valve. Heterotopic tissue was confirmed on histopathology in 75% of all patients, including 10 cases of gastric mucosa, 3 cases of coexistent gastric mucosa and pancreatic tissue, and 2 cases of pancreatic tissue. All patients underwent diverticulectomy or partial ileal resection under laparoscopy or laparotomy; two cases combined with appendectomy owing to slight inflammation of the appendix.
Conclusions
The most common presentation of symptomatic MD is painless rectal bleeding; however, it can present symptoms of acute abdomen mimicking acute appendicitis. The key point of diverticulectomy is to remove the ectopic mucosa completely.
Publisher
Springer Science and Business Media LLC
Reference20 articles.
1. Ruscher KA, Fisher JN, Hughes CD, et al. National trends in the surgical management of Meckel’s diverticulum. J Pediatr Surg. 2011;46:893–6.
2. Stanescu GL, Plesea IE, Diaconu R, et al. Meckel’s diverticulum in children, clinical and pathological aspects. Rom J Morphol Embryol. 2014;55(suppl 3):1167–70.
3. Gezer HÖ, Temiz A, Ince E, Ezer SS, Hasbay B, Hiçsönmez A, et al. Meckel diverticulum in children: evaluation of macroscopic appearance for guidance in subsequent surgery. J Pediatr Surg. 2016;51:1177–80.
4. Eisdorfer J, Zinkin NT, Rivadeneira DE. Meckel’s diverticulitis: a rare cause of abdominal pain during pregnancy. ANZ J Surg. 2018;88(7–8):800–2.
5. Park JJ, Wolff BG, Tollefson MK, et al. Meckel diverticulum: the Mayo Clinic experience with 1476 patients (1950–2002). Ann Surg. 2005;241:529–33.
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