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KMID : 1152420210270010008
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Advances in Pediatric Surgery
2021 Volume.27 No. 1 p.8 ~ p.14
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Clinicopathologic Characteristics and Treatment Outcomes of Symptomatic Meckel's Diverticulum in Children
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Shin Hyun-Wook
Kang Yoo-Na
Park Jin-Young
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Abstract
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Purpose: Meckel's diverticulum (MD) is the most common congenital malformation of the gastrointestinal tract. The clinical presentation of MD is nonspecific and various, which can make diagnosis difficult. The aim of this study was to analyze the clinicopathologic characteristics and treatment outcomes of symptomatic MD in children.
Methods: We retrospectively reviewed the medical records of 38 pediatric patients diagnosed with MD who underwent surgery from April 1999 to September 2017. Five MD cases which were found incidentally during another surgery were excluded from this study. Sex, age, clinical presentation, diagnostic method, surgical treatment, histopathological findings were analyzed.
Results: Twenty-five cases occurred in boys and 8 cases occurred in girls. At the time of diagnosis, the age ranged from 6 months to 17 years, with an average of 92.4 months. Thirteen patients (39.4%) were presented with melena, 7 patients (21.2%) with intestinal obstruction, 5 patients (15.2%) with intussusception, 5 patients (15.2%) with perforation, and 3 patients (9%) with diverticulitis. Meckel's scan was performed in 12 out of 13 patients with lower gastrointestinal bleeding, and all 12 (100%) showed a positive tracer. Out of total 33 patients, 12 underwent laparoscopic assisted bowel resection, 7 underwent laparoscopic assisted diverticulectomy, 5 underwent laparoscopic diverticulectomy, 7 underwent open bowel resection, and 2 underwent open diverticulectomy. There was only 1 postoperative wound infection in all 33 cases. There were 21 (63.6%) ectopic tissues in 33 symptomatic MD patients. Gastric mucosa was observed in 19 patients (57.6%), pancreatic tissue was found in 1 patient (3%), and both gastric mucosa and pancreatic tissue was present in 1 patient (3%).
Conclusion: Surgical resection of MD is safe and effective in symptomatic MD. Laparoscopic or laparoscopic assisted diverticulectomy or bowel resection is the treatment option for symptomatic MD.
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KEYWORD
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Meckel's diverticulum, Surgery, Children
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