| Objective:To investigate the age trend of Meiker diverticulum,the relationship between clinical symptoms and age,sex,the application of auxiliary examination,the effect of surgical approach on the prognosis of children by analyzing the clinical data of 137patients with Merkel diverticulum,to provide a better and comprehensive understanding on Kerr diverticulum and its complications in hope to improve the early diagnosis of Meiker diverticulum,reduce diagnosis errors,and offer more suggestions on the options of surgery.Methods:We performed a retrospective analysis on the clinical data of 137 children who were diagnosed with Merckel diverticulum by surgery or postoperative pathology during the period from January 2006 to February 2017 in the Children's Hospital of Suzhou University,clinical manifestations,preoperative examinations,imaging data,preoperative preparation,surgical methods,pathological results were collected and recorded.We conducted data analysis using independent sample t test et al in SPSS for Windows20.0software.Results:1.137 cases of Merkel diverticular children were included finally,with 111 male children?81.02%?and female children?18.98%?,the ratio of male to female was 4.26:1;children aged between 4 days and 14 years old?average age was 48 months?.2.?1?79 cases of children showed gastrointestinal bleeding symptoms,74 cases showed painless bleeding as the main symptoms,accompanied by 5 cases of abdominal pain?crying?,the blood volume ranged from 50 to 300ml,and the blood traits of stools were different,58 cases showed dark red stools,16 cases showed jelly-like stools,3 cases showed melena,2 cases showed blood;?2?31 cases showed Merkel diverticular inflammation,and complained abdominal pain?crying?as the main clinical manifestations,the part of abdominal pain was not fixed and right lower abdominal pain is the most common,of them 10 cases showed vomiting,7 cases showed fever,accompanied by 3cases of bloody stool,with 4 cases of inflammation perforation;?3?27 cases of children showed intestinal obstruction symptoms,with 19 cases of abdominal distension,22 cases of vomiting?17 cases showed vomiting as the first symptom?,8 cases showed no defecation,accompanied by 5 cases of bloody stools,2 cases of fever,and 2 cases of perforation in confirmed in the operation.3.60 cases of children were undertaken the preoperative 99mTc nuclide scan,of which 55?91.67%?cases suggested that there might be Meckel diverticulum.4.All the included children underwent surgical treatment.All the Merkel diverticulum in our study was located on the contralateral small intestine margin of the mesentery,the distance was about 47.32cm±14.78cm from the ileoceae,and the average distance was about 48cm,The maximum length of the diverticulum was 10 cm,the shortest distance was 1.0 cm,the average length was 3.6 cm,the basal width of the diverticulum was 1.5±0.7 cm and the average width was 1.5 cm.67 cases of children underwent bowel anastomosis,the average resection length of bowel was about 5.8cm,and 70 cases of children underwent simple Merkel diverticulum resection.The average length of hospital stay was 8.28±2.10 days.Among them,72 cases were treated with routine laparotomy with 9.08±2.01 days of average length of hospital stay,65 cases were treated with laparoscopic assisted surgery with 7.28±1.65 days of average length of hospital stay,The difference length of hospital stay between two surgeries was statistically significant with p<0.01.5.Pathological results showed that there were 53 cases of intestinal mucosa,78 cases of gastric mucosa,3 cases of pancreatic tissue,3 cases of gastric mucosa and pancreas.Conclusions:1.Children Merkel diverticulum showed gastrointestinal bleeding as the main clinical manifestation,followed by diverticulitis and intestinal obstruction,and these complications can happens in parallel.2.99mTc radionuclide scan has a higher accuracy,thus it is the preferred method on the diagnosis of Merkel diverticulum,but for children with negative results of scanning nuclide,surgical exploration should be performed for confirmed diagnosis.3.Laparoscopic surgery show more advantages on less surgery injuries and faster postoperative healing compared with conventional open surgery. |
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