Meckel's Diverticulum in Children-Parameters Predicting the Presence of Gastric Heterotopia
Language English Country United States Media print
Document type Journal Article
PubMed
29750325
DOI
10.1007/s00268-018-4664-0
PII: 10.1007/s00268-018-4664-0
Knihovny.cz E-resources
- MeSH
- Choristoma pathology surgery MeSH
- Child MeSH
- Cohort Studies MeSH
- Infant MeSH
- Laparoscopy MeSH
- Laparotomy MeSH
- Humans MeSH
- Meckel Diverticulum pathology surgery MeSH
- Adolescent MeSH
- Child, Preschool MeSH
- Retrospective Studies MeSH
- Gastric Mucosa * MeSH
- Check Tag
- Child MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
BACKGROUND: The presence of gastric ectopic mucosa in Meckel's diverticulum is associated with a higher risk of development of complications. The aim of the present study was to investigate which demographic/clinical parameters predict the presence of gastric heterotopia in Meckel's diverticulum. METHODS: This was a retrospective cohort study conducted in a single institution (University Hospital Ostrava, Czech republic). All children who underwent laparoscopic/open resection of Meckel's diverticulum within a 20-year study period were included in the study. RESULTS: In total, 88 pediatric patients underwent analysis. The mean age of the children was 4.6 ± 4.73 years; the male-female ratio was approximately 2:1. There were 50 (56.8%) patients with asymptomatic Meckel's diverticulum in our study group. Laparoscopic resection was performed in 24 (27.3%) patients; segmental bowel resection through laparotomy was performed in 13 (14.8%) patients. Gastric heterotopia was found in 39 (44.3%) patients; resection margins of all patients were clear of gastric heterotopia. No correlation was found between the presence of gastric heterotopia and the following parameters: age, gender, maternal age, prematurity, low birth weight, perinatal asphyxia, distance from Bauhin's valve and length of Meckel's diverticulum. The width of the diverticulum base was significantly higher in patients with gastric heterotopia (2.1 ± 0.57 vs. 1.2 ± 0.41 cm; p < 0.001). CONCLUSIONS: According to the study outcomes, the width of the diverticulum base seems to be a significant predictive factor associated with the presence of gastric heterotopia in Meckel's diverticulum. The laparoscopic/open resection of asymptomatic MD with a wide base should therefore be recommended.
See more in PubMed
Francis A, Kantarovich D, Khoshnam N et al (2016) Pediatric Meckel’s diverticulum: report of 208 cases and review of the literature. Fetal Pediatr Pathol 35(3):199–206 DOI
Çelebi S (2017) Male predominance in Meckel’s diverticulum: a hyperacidity hypotheses. Med Hypotheses 104:54–57 DOI
Cserni G (1996) Gastric pathology in Meckel’s diverticulum. Review of cases resected between 1965 and 1995. Am J Clin Pathol 106(6):782–785 DOI
Sagar J, Kumar V, Shah DK (2006) Meckel’s diverticulum: a systematic review. J R Soc Med 99:501–505 DOI
Robinson JR, Correa H, Brinkman AS et al (2017) Optimizing surgical resection of the bleeding Meckel diverticulum in children. J Pediatr Surg 52(10):1610–1615 DOI
Stone PA, Hofeldt MJ, Campbell JE et al (2004) Meckel diverticulum: ten-year experience in adults. South Med J 97(11):1038–1041 DOI
Ergün O, Celik A, Akarca US et al (2002) Does colonization of Helicobacter pylori in the heterotopic gastric mucosa play a role in bleeding of Meckel’s diverticulum? J Ped Surg 37(11):1540–1542 DOI
Groebli Y, Berlin D, Morel P (2001) Meckel’s diverticulum in adults: retrospective analysis of 119 cases and historical review. Eur J Surg 167:518–524 DOI
Park JJ, Wolff BG, Tollefson MK et al (2005) Meckel diverticulum: the Mayo clinic experience with 1476 patients (1950–2002). Ann Surg 241:529–533 DOI
Ruscher KA, Fisher JN, Hughes CD et al (2011) National trends in the surgical management of Meckel’s diverticulum. J Pediatr Surg 46:893–896 DOI
Zani A, Eaton S, Rees CM et al (2008) Incidentally detected Meckel diverticulum: to resect or not to resect? Ann Surg 247:276–281 DOI
Lequet J, Menahem B, Alves A et al (2017) Meckel’s diverticulum in the adult. J Visc Surg 154(4):253–259 DOI
Meckel JF (1809) Über die Divertikel am Darmkanal. Archiv für die Physiologie (Halle) 9:421–453
Dumper J, Mackenzie S, Mitchell P et al (2006) Complications of Meckel’s diverticula in adults. Can J Surg 49:353–357 PubMed PMC
Cullen JJ, Kelly KA, Moir CR et al (1994) Surgical management of Meckel’s diverticulum. An epidemiologic, population-based study. Ann Surg 220:564–568 DOI
Bani-Hani KE, Shatnawi NJ (2004) Meckel’s diverticulum: comparison of incidental and symptomatic cases. World J Surg 28:917–920. https://doi.org/10.1007/s00268-004-7512-3 PubMed DOI
Soltero MA, Bill AH (1976) The natural history of Meckel’s diverticulum and its relation to incidental removal. Am J Surg 132:168–173 DOI
Mackey WC, Dineen P (1983) A fifty year experience with Meckel’s diverticulum. Surg Gynecol Obstet 156:56–64 PubMed
Blaser MJ (1987) Gastric campylobacter-like organisms, gastritis and peptic ulcer disease. Gastroenterology 93:371–383 DOI
Lee KH, Yeung CK, Tam YH et al (2000) Laparoscopy for definitive diagnosis and treatment of gastrointestinal bleeding of obscure origin in children. J Pediatric Surg 35(9):1291–1293 DOI
Chan KW, Lee KH, Mou JW et al (2008) Laparoscopic management of complicated Meckel’s diverticulum in children: a 10-year review. Surg Endosc 22(6):1509–1512 DOI
Mukai M, Takamatsu H, Noguchi H et al (2002) Does the external appearance of a Meckel’s diverticulum assist in choice of the laparoscopic procedure? Pediatr Surg Int 18(4):231–233 DOI
Palanivelu C, Rangarajan M, Senthilkumar R et al (2008) Laparoscopic management of symptomatic Meckel’s diverticulum. JSLS 12(1):66–70 PubMed PMC