Clinical diagnosis and treatment of Meckel's diverticulum in children
10.3760/cma.j.issn.1007-631X.2017.08.012
- VernacularTitle:儿童美克尔憩室临床诊治分析
- Author:
Yan MA
;
Zhigang GAO
;
Lifeng ZHANG
;
Yuebin ZHANG
;
Tao PAN
;
Duote CAI
;
Qixing XIONG
;
Qiang SHU
;
Qingjiang CHEN
- Keywords:
Meckel's diverticulum;
Gastrointestinal hemorrhage;
Ectopic mucosa
- From:
Chinese Journal of General Surgery
2017;32(8):674-677
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical characteristics and pathological features of Meckel's diverticulum(MD) in children.Methods 244 MD cases admitted between January 2010 and December 2014 were retropectively analyzed.Results In fifty patients,MD was an incidental finding at laparotomy or laparoscopy for unrelated entities.Among the remaining 194 symptomatic patients,there were 76 patients presenting GI bleeding,forty eight patients were identified with perforated Meckel's diverticulum,thirty six patients suffered from intestinal obstruction.34 patients had MD caused severe complications such as volvulus and intestinal necrosis,diverticular perforation and peritonitis.61 out of 76 GI bleeding patients underwent a 99mTc scan,and positive tracer was found in 42 patients.Among the 19 negative 99mTc scan patients,8 received capsule endoscopy and only 3 patients were suspected of diverticulum.242 patients underwent one stage resection of the diverticulum.Histology revealed ectopic gastric mucosa or ectopic pancreatic tissue in 128 patients.One patient died of volvulus and intestinal necrosis postoperatively,and two suffered from adhesive intestinal obstruction during one to five year's follow up.Conclusions It is necessary to maintain a high suspicion of MD in the pediatric age group with symptoms of abdominal pain,gastrointestinal hemorrhage or intestinal obstruction.Ectopic mucosa assumes the ultimate responsibility for major complications of MD.
