Meckel diverticulum in children: Evaluation of macroscopic appearance for guidance in subsequent surgery

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• 作者：Hasan Ö ; zkan Gezer^a ; ^{hozkangezer@yahoo.com.tr" class="auth_mail" title="E-mail the corresponding author} ; Abdulkerim Temiz^a ; ^{aktemiz@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Emine İnce^a ; ^{inceemine@mynet.com" class="auth_mail" title="E-mail the corresponding author} ; Semire Serin Ezer^a ; ^{semireserin@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Bermal Hasbay^b ; ^{bermalhasbay@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Akgun Hiç ; sö ; nmez^a ; ^{akgunhicsonmez@gmail.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Meckel diverticulum ; Children ; Macroscopic appearance ; Incidentally ; Prophylactic
• 刊名：Journal of Pediatric Surgery
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：51
• 期：7
• 页码：1177-1180
• 全文大小：500 K

文摘

The treatment of incidentally encountered asymptomatic Meckel diverticulum (MD) is controversial. We evaluated whether the macroscopic appearance correlates with clinical features, histopathological findings, future complications, and management decisions.

Methods

Patients who underwent MD resection at a single institution from 2000 to 2012 were retrospectively analyzed in terms of age, sex, clinical features, laboratory data, perioperative findings (diverticulum length, diameter, depth, thickening, and height-to diameter ratio [HDR]), pathology, and postoperative follow-up.

Results

Fifty children were enrolled. Sixteen percent of the resected MDs were found incidentally. Of 42 complicated MDs, 17 (40%) were long (HDR ≥ 2), 14 (33%) were thickened, and 29 (70%) exhibited base widening. Histopathologically, ectopic mucosa was found in 32 (64%) of all MDs and in 5 (62%) of incidentally removed MDs. There was no statistical difference between the macroscopic appearance and clinical signs, sex, or presence of ectopic tissue based on palpation.

Conclusion

The macroscopic appearance of MD does not indicate the presence or absence of HGM and cannot be used to guide subsequent surgery. Additionally, 40% of symptomatic patients in our study had life-threatening complications requiring prompt fluid resuscitation. We consider that incidentally detected MD should be removed regardless of its macroscopic appearance.