Meckel’s Diverticulum In Children: Clinical Analysis Of 19 Cases

Objective: To summarize the clinical characteristics of Meckel’s diverticulum.Methods: 19 patients with Meckel’s diverticulum from May 2008 to June 2014 were confirmed by surgery and pathological examination. They were retrospectively analyzed by reviewing and following up.Results: 19 patients(14males and 5 females) with Meckel’s diverticulum, according to clinical manifestations, digestive symptoms of 19 cases including 3 cases with vomiting(15.8%),15 cases with bloody tool(78.9%),11 cases with abdominal pain(57.9%). ①Among 15 cases with bloody tool, 5 cases with varying degrees of anemia, 8 cases with tarry stool, 4 cases with dark red colored bloody stool, 3 cases with red blood stool. Among 11 cases with paroxysmal or persistent abdominal pain, 5 cases with intestinal obstruction(26.3%).2 cases combine with peritonitis. ②Among 14 cases with Meckel’s diverticulum, 11 cases who had positive finding of 99 mTc ectopic gastric mucous membrane imaging occurred Meckel’ diverticulum operation. ③Open surgery was performed on 17 cases and trans-umbilicus two-port laparoscopic procedures therapy on 2 cases. Meckel’s diverticulum located on ileocecal or terminal ileum about 15~70cm, averages 48 cm. All of the diverticulum located on the contralateral by the ileal mesentery.The length of diverticulum is about 0.8~10cm, averages 5.0 cm. The diameter of basilar diverticulum is about 0.7~3 cm, averages 1.9 cm. Range of bowel resection about 3.5~26 cm, averages 9.4 cm.④Operation Histopathologic examinatuin was carried out in 19 cases with Meckel’s diverticulum operation,all cases were confirmed as Meckel’s diverticulum and with ectopic mucosal epithelium, accompanied by diverticulum infection and hemorrhage and necrosis,ulceration,chronic appendicitis,intestinal bleeding necrosis,focal peritonitis,small patches of pancreatic tissue. 19 cases with digestive canal bleeding due to unknown causes, postoperative pathology showed: Syn, AACT(+), Cg A scattered(+), Lysozme(-).Conclusions:①Children with Meckel diverticulum are more common in males.The ratio between men and women is roughly around 2.8 to 1; ②The clinical manifestations of Meckel diverticulum can be abdominal pain, with bloody tool,abdominal distention, peritonitis, bowel obstruction or bleeding etc. ③Meckel’s diverticulum located on ileocecal or terminal ileum averages 48 cm. ④99mTc gastrointestinal imaging is helpful to diagnosis of Meckel’s diverticulum diseases. ⑤Surgical resection was the treatment of Meckel’s diverticulum.