Authors: YiYuan Tseng YaoJong Yang
Publish Date: 2009/07/03
Volume: 168, Issue: 12, Pages: 1519-1523
Abstract
Meckel’s diverticulum MD has varied clinical manifestations and is a diagnostic challenge for pediatricians This study investigates the clinical and diagnostic characteristics of MD in children with different presentations We retrospectively reviewed the medical records of pediatric patients diagnosed with MD from 1988 to 2008 The data including the age sex clinical features laboratory data sensitivity of diagnostic methods and pathological finding were recorded These patients were classified into three groups diverticulitis intestinal obstruction and intestinal bleeding A total of 47 children 35 boys and 12 girls with a median age of 56 years were enrolled and categorized as follows diverticulitis n = 12 obstruction n = 12 bleeding n = 21 and two diagnosed incidentally Patients with intestinal obstruction were significantly younger than those with bleeding 37 95 CI 16–57 vs 66 95 CI 4587 P = 004 In the obstruction group intussusception was found in eight of 12 patients of whom 625 were aged older than 3 years Heterotopic tissues were found in 463 of surgical specimens and more frequently existed in patients with bleeding than those with diverticulitis P = 002 and obstruction P = 0047 Tc99m scans yielded a diagnostic sensitivity of about 65 in bleeding patients Repeated Tc99m scans and red blood cell RBC scans can be good supplementary tools in Tc99m scannegative bleeding patients In conclusion manifestations of childhood MD are variable and may depend on the presence of heterotopic tissues and the patients’ age Tc99m scans supplemented with RBC scans are appropriate to diagnose childhood MD with bleeding
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