Management of Symptomatic Meckel's Diverticulum in Infants and Children

Objectives The primary objective of the present study was to review the demographics of infants and children operated upon for Meckel's diverticulum. The secondary objectives were to review the clinical characteristics, surgical procedures performed, postoperative complications, and the outcome...

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Autor principal:	Rajendra K. Ghritlaharey
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2021
Materias:	children infants intestinal obstruction intussusception meckel's diverticulum meckel's diverticulectomy perforation peritonitis General works R5-130.5 Science Q
Acceso en línea:	https://doaj.org/article/a3330f3000fb405a8649c5abff6358f1
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spelling	oai:doaj.org-article:a3330f3000fb405a8649c5abff6358f12021-11-06T00:17:05ZManagement of Symptomatic Meckel's Diverticulum in Infants and Children0379-038X2454-563510.1055/s-0041-1739190https://doaj.org/article/a3330f3000fb405a8649c5abff6358f12021-11-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1739190https://doaj.org/toc/0379-038Xhttps://doaj.org/toc/2454-5635Objectives The primary objective of the present study was to review the demographics of infants and children operated upon for Meckel's diverticulum. The secondary objectives were to review the clinical characteristics, surgical procedures performed, postoperative complications, and the outcome. Materials and Methods This study is a single-institutional, retrospective study and descriptive in nature. It consisted of infants and children below 12 years who were operated upon for Meckel's diverticulum. This study was conducted at the author's department of pediatric surgery, and it was performed for 21 years from January 1, 2000 to December 31, 2020. Results Eighty-four children below 12 years were operated upon for Meckel's diverticulum during the study period of 21 years. The ratio for males to females was 3:1. This study consisted of infants, (n = 22, 26.19%), children of 1 to 5 years of age (n =19, 22.61%), and children of 6 to 12 years of age (n = 43, 51.19%). Clinically, children with Meckel's diverticulum presented in the following order of frequency: (1) intestinal obstruction (n = 59, 70.23%), (2) perforation peritonitis (n = 17, 20.23%), (3) lower gastrointestinal bleeding (n = 4, 4.76%), and (4) incidental finding (n = 4, 4.76%). In 35 (41.66%) children, bowel gangrene was detected. One-fifth (n = 17) of Meckel's diverticulum was responsible for the secondary intussusception. In children (n = 84), for Meckel's diverticulum, surgical procedures were performed in the following order of frequency: (1) resection of Meckel's diverticulum, an adjacent segment of ileum and ileoileal anastomosis (n = 36, 42.85%); (2) Meckel's diverticulectomy (n = 32, 38.09%); (3) resection of Meckel's diverticulum, an adjacent segment of ileum with or without cecum and an ileostomy (n = 12, 14.28%); and (4) resection of Meckel's diverticulum, an adjacent segment of ileum, cecum, part of the colon, and ileocolic anastomosis (n = 4, 4.76%). In 8 (9.52%) children, complications were documented during the postoperative period. The present study observed three (3.57%) deaths during the postoperative period. Conclusion Meckel's diverticulum was one of the common causes of acute intestinal obstruction in infants and older children. Ninety percent of children with Meckel's diverticulum presented with features of an acute abdomen. Forty percent of children evidenced bowel gangrene during the surgical procedures. In these children, early diagnosis, timely referral, and institution of surgical therapy for acute abdomen/intestinal obstruction may prevent the development of bowel gangrene and the requirement of bowel resections to some extent.Rajendra K. GhritlahareyThieme Medical and Scientific Publishers Pvt. Ltd.articlechildreninfantsintestinal obstructionintussusceptionmeckel's diverticulummeckel's diverticulectomyperforation peritonitisGeneral worksR5-130.5ScienceQENAnnals of the National Academy of Medical Sciences (India) (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	children infants intestinal obstruction intussusception meckel's diverticulum meckel's diverticulectomy perforation peritonitis General works R5-130.5 Science Q
spellingShingle	children infants intestinal obstruction intussusception meckel's diverticulum meckel's diverticulectomy perforation peritonitis General works R5-130.5 Science Q Rajendra K. Ghritlaharey Management of Symptomatic Meckel's Diverticulum in Infants and Children
description	Objectives The primary objective of the present study was to review the demographics of infants and children operated upon for Meckel's diverticulum. The secondary objectives were to review the clinical characteristics, surgical procedures performed, postoperative complications, and the outcome. Materials and Methods This study is a single-institutional, retrospective study and descriptive in nature. It consisted of infants and children below 12 years who were operated upon for Meckel's diverticulum. This study was conducted at the author's department of pediatric surgery, and it was performed for 21 years from January 1, 2000 to December 31, 2020. Results Eighty-four children below 12 years were operated upon for Meckel's diverticulum during the study period of 21 years. The ratio for males to females was 3:1. This study consisted of infants, (n = 22, 26.19%), children of 1 to 5 years of age (n =19, 22.61%), and children of 6 to 12 years of age (n = 43, 51.19%). Clinically, children with Meckel's diverticulum presented in the following order of frequency: (1) intestinal obstruction (n = 59, 70.23%), (2) perforation peritonitis (n = 17, 20.23%), (3) lower gastrointestinal bleeding (n = 4, 4.76%), and (4) incidental finding (n = 4, 4.76%). In 35 (41.66%) children, bowel gangrene was detected. One-fifth (n = 17) of Meckel's diverticulum was responsible for the secondary intussusception. In children (n = 84), for Meckel's diverticulum, surgical procedures were performed in the following order of frequency: (1) resection of Meckel's diverticulum, an adjacent segment of ileum and ileoileal anastomosis (n = 36, 42.85%); (2) Meckel's diverticulectomy (n = 32, 38.09%); (3) resection of Meckel's diverticulum, an adjacent segment of ileum with or without cecum and an ileostomy (n = 12, 14.28%); and (4) resection of Meckel's diverticulum, an adjacent segment of ileum, cecum, part of the colon, and ileocolic anastomosis (n = 4, 4.76%). In 8 (9.52%) children, complications were documented during the postoperative period. The present study observed three (3.57%) deaths during the postoperative period. Conclusion Meckel's diverticulum was one of the common causes of acute intestinal obstruction in infants and older children. Ninety percent of children with Meckel's diverticulum presented with features of an acute abdomen. Forty percent of children evidenced bowel gangrene during the surgical procedures. In these children, early diagnosis, timely referral, and institution of surgical therapy for acute abdomen/intestinal obstruction may prevent the development of bowel gangrene and the requirement of bowel resections to some extent.
format	article
author	Rajendra K. Ghritlaharey
author_facet	Rajendra K. Ghritlaharey
author_sort	Rajendra K. Ghritlaharey
title	Management of Symptomatic Meckel's Diverticulum in Infants and Children
title_short	Management of Symptomatic Meckel's Diverticulum in Infants and Children
title_full	Management of Symptomatic Meckel's Diverticulum in Infants and Children
title_fullStr	Management of Symptomatic Meckel's Diverticulum in Infants and Children
title_full_unstemmed	Management of Symptomatic Meckel's Diverticulum in Infants and Children
title_sort	management of symptomatic meckel's diverticulum in infants and children
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2021
url	https://doaj.org/article/a3330f3000fb405a8649c5abff6358f1
work_keys_str_mv	AT rajendrakghritlaharey managementofsymptomaticmeckelsdiverticulumininfantsandchildren
_version_	1718443997772382208

Management of Symptomatic Meckel's Diverticulum in Infants and Children

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