Meckel's Diverticulum in Children

Abstract

Purpose : Meckel's diverticulum (MD) is the most common developmental abnormality of the gastrointestinal tract. We compared symptomatic cases with asymptomatic ones according to clinical and pathologic features, and assessed whether asymptomatic MD should be resected or not. Methods : Thirty five patients have had MD resected at our institute. Of the 35 cases, ten were symptomatic, and 25 were asymptomatic. The 25 asymptomatic cases were diagnosed incidentally during laparotomy. All ten symptomatic cases had typical presentations. All cases (both symptomatic and asymptomatic) were classified into two groups according to the presence of the ectopic gastric mucosa. The two groups were compared with respect to the gross appearance of the MD. Results : In the ten symptomatic cases, eight had rectal bleeding, one had peritonitis due to perforation of the diverticulum, and one had bowel obstruction. In seven cases which had chronic gastritis associated with MD, Helicobacter pylori organisums could not be identified. Ectopic gastric mucosa was observed in all cases with rectal bleeding, and was considered to play an important role in bleeding. MD with ectopic gastric mucosa is also likely to be folded over into the mesentery, and be attached to the mesodiverticular band. Conclusions : Although the chance of complications from MD found incidentally is difficult to assess, there is a possibility of primary gastrointestinal neoplasms developing in MD and they should be resected because of this in all cases.