Diagnosis and treatment of Meckel diverticulum complicated with intestinal obstruction in children:an analysis of 103 cases in a single center
10.16781/j.CN31-2187/R.20230573
- VernacularTitle:单中心103例小儿梅克尔憩室并发肠梗阻临床诊疗分析
- Author:
Zhenchuang ZHU
1
;
Xueqiang YAN
;
Houfang KUANG
;
Xufei DUAN
;
Fei PENG
;
Xinke QIN
Author Information
1. 华中科技大学同济医学院附属武汉儿童医院普外科,武汉 430016
- Keywords:
children;
Meckel diverticulum;
intestinal obstruction;
secondary intussusception
- From:
Academic Journal of Naval Medical University
2025;46(3):418-421
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical characteristics of intestinal obstruction caused by Meckel diverticulum in children,so as to improve the understanding,diagnosis and treatment of this disease.Methods The clinical data of 103 children with intestinal obstruction caused by Meckel diverticulum admitted to Department of General Surgery,Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science and Technology from Jul.2015 to Jun.2022 were retrospectively analyzed.There were 78 males and 25 females,with an average age of(4.7±2.6)years old(ranged from 4 months to 12 years old).All 103 cases were admitted for abdominal pain,crying,vomiting or abdominal distension with unknown causes.Results Seventy-four children underwent exploratory laparotomy and 29 underwent laparoscopic exploration.During the operation,it was found that Meckel diverticulum combined with the formation of cord oppressed the intestinal tract,resulting in intestinal obstruction in 65 cases;diverticulum perforation and adhesion obstruction in 15 cases;and secondary intussusception leading to obstruction in 23 cases.Twenty-three cases of secondary intussusception underwent manual reduction of intussusception and Meckel diverticulectomy.Thirty-nine cases were complicated with intestinal necrosis,of which 38 cases underwent cord release,necrotic bowel resection,and intestinal anastomosis;1 case underwent necrotic bowel resection and intestinal fistula due to septic shock.Twelve cases underwent cord release and diverticulectomy,14 cases underwent laparoscopic cord release and diverticulectomy,and 15 cases underwent laparoscopic surgery conversion to diverticulectomy.All patients were clinically cured and followed up for more than 1 year,and no anastomotic leakage,wound infection or other complications occurred.Conclusion The formation of cord is the main cause of intestinal obstruction caused by Meckel diverticulum,with atypical early symptoms,lack of specific symptoms,signs and examination methods,leading to a high misdiagnosis rate.It often causes serious complications such as intestinal necrosis and septic shock.For cases of intestinal obstruction with unknown causes,we should be alert to the possibility of intestinal obstruction caused by Meckel diverticulum.
