A Review of 24 Cases of Symptomatic Pediatric Meckel’s Diverticulum Experienced Over a 20-year Period from 2006 to 2025

Abstract

Purpose: We investigated the pathogenesis of symptomatic pediatric cases caused by Meckel’s diverticulum.

Method: The study included 24 cases of symptomatic pediatric Meckel’s diverticulum seen at our hospital over a 20-year period.

Results: The age distribution ranged from 4 days to 13 years of age, with 14 boys and 10 girls. There were five cases of advanced intussusception, eight cases of internal hernia due to a Meckel’s diverticulum band, eight cases of positive Meckel’s scintigraphy as a diagnosis of melena, and three cases of Meckel’s diverticulum perforation. Seven cases underwent open surgery, 15 cases underwent laparoscopy, and two cases were converted from laparoscopy to open surgery. Four cases had a Meckel’s diverticulum diagnosed preoperatively by abdominal ultrasound or CT. In terms of age distribution, one case was under one month of age and had a Meckel’s diverticulum perforation. Five cases were between one month and one year of age, with a breakdown of Meckel’s diverticulum. There was one case with a positive Kelsinchi scintigram, one had a leading site due to intussusception, and three had internal hernias due to Meckel’s diverticulum bands. There were 18 cases over the age of one, including five with internal hernias due to Meckel’s diverticulum bands, seven with positive Meckel’s scintigrams, four with leading sites due to intussusception, and two with perforations. Of the three cases with perforations, two had ectopic gastric mucosa, and one had no ectopic gastric mucosa but a partial defect of the muscularis propria. The perforation is thought to have been caused by increased intestinal pressure within the Meckel’s diverticulum due to meconium plug syndrome.

Conclusion: Symptomatic Meckel’s diverticulum is a cause of acute abdominal pain in children, but its pathology may also be due to intussusception with the Meckel’s diverticulum as the leading part, perforation of the Meckel’s diverticulum, or intestinal obstruction due to internal hernia caused by a Meckel’s diverticulum band, so it should be considered in the differential diagnosis.