KMID : 0605920070130020127
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Journal of Korean Association of Pediatric Surgeons 2007 Volume.13 No. 2 p.127 ~ p.134
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Complications of Meckel¡¯s Diverticulum in Children.
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Jun Heung-Man
Nam So-Hyun Kim Dae-Yeon Kim Seong-Chul Kim In-Koo
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Abstract
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Meckel¡¯s diverticulum is the most common congenital anomaly of gastrointestinal tract in children. The incidence of complicated Meckel¡¯s diverticulum is about 4%. The major complications of Meckel¡¯s diverticulum are bleeding, intussusception, obstruction and perforation. The aim of this study was to investigate the clinical manifestations and the role of laparoscopic surgery in complicated Meckel¡¯s diverticulum in children. We retrospectively reviewed the medical records of 19 patients with complicated Meckel¡¯s diverticulum who underwent operation at Asan Medical Center between Jan. 1990 and Apr. 2007. Male to female ratio was 11:8, and median age was 1 year (1 day-13 years). The most frequent symptom was hematochezia (68%), followed by irritability or abdominal pain (16%), vomiting (11%), and abdominal distension (5%). Two operative procedures were performed; small bowel resection with anastomosis (68%) and diverticulectomy (32%). The operation proven complications of the Meckel¡¯s diverticulum were bleeding (68%), intussusception (16%), perforation (11%) and obstruction (5%). Ectopic tissues found by postoperative pathologic examination were gastric (84%) and pancreatic (11%). Hospital stay after laparoscopic operation for bleeding Meckel¡¯s was 5 days (median) and average first postoperative feeding was 1.5 days. On the contrary, hospital stay for open surgery was 7 days and first feed was 3 days. In summary, the most common compliation of Meckel¡¯s diverticulum in children was bleeding and ectopic gastric tissues were present in 84%. Laparoscopic procedure seemed to be useful for diagnosis as well as for definitive treatment.
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KEYWORD
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Meckel¡¯s diverticulum, Complication, Children
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