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Published in: Surgical Endoscopy 6/2008

01-06-2008

Laparoscopic management of complicated Meckel’s diverticulum in children: a 10-year review

Authors: K. W. Chan, K. H. Lee, J. W. C. Mou, S. T. Cheung, Y. H. Tam

Published in: Surgical Endoscopy | Issue 6/2008

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Abstract

Background

Meckel’s diverticulum, the most common congenital anomaly of the gastrointestinal tract, is prone to develop complications in the pediatric population. The authors report their 10-year experience with the management of complicated Meckel’s diverticulum in children using laparoscopy.

Methods

A retrospective review of all complicated Meckel’s diverticulum cases involving children from 1998 to 2007 was performed. The efficacy and safety of laparoscopy used to manage complicated Meckel’s diverticulum were assessed.

Results

Over a 10-year period, 20 children (17 boys and 3 girls) with a mean age of 5 years (range, 7 months to 13 years) were included in the study. Of the 20 children, 12 presented with gastrointestinal bleeding, 2 had intestinal obstruction, 3 had abdominal pain mimicking acute appendicitis, 2 had inguinal hernia, and 1 had intussusception. Diagnostic laparoscopy was performed for all the patients. Laparoscopically assisted transumbilical Meckel’s diverticulectomy was performed successfully for 18 of the children. The operative time ranged from 50 to 190 min (mean, 115 min). All the children had an uneventful recovery except one, who experienced a postoperative wound infection. Ectopic gastric mucosa was found in 14 cases.

Conclusions

Diverse pediatric surgical conditions result from Meckel’s diverticulum. Laparoscopy is a safe and effective method for the management of complicated Meckel’s diverticulum.
Literature
1.
go back to reference Moore TC (1996) Omphalomesenteric duct malformations. Semin Pediatr Surg 5:116–123PubMed Moore TC (1996) Omphalomesenteric duct malformations. Semin Pediatr Surg 5:116–123PubMed
2.
go back to reference Malhotra S, Roth DA, Gouge TH (1998) Gangrene of Meckel’s diverticulum secondary to axial torsion: a rare complication. Am J Gastroenterol 93:1373–1375PubMedCrossRef Malhotra S, Roth DA, Gouge TH (1998) Gangrene of Meckel’s diverticulum secondary to axial torsion: a rare complication. Am J Gastroenterol 93:1373–1375PubMedCrossRef
3.
go back to reference Levy AD, Hobbs CM (2004) Meckel diverticulum: radiologic features with pathologic correlation. Radiographics 24:565–587PubMedCrossRef Levy AD, Hobbs CM (2004) Meckel diverticulum: radiologic features with pathologic correlation. Radiographics 24:565–587PubMedCrossRef
4.
go back to reference Lu CC, Huang FC, Lee SY, Huang HY (2003) Laparoscopy diagnosis and treatment excision of bleeding Meckel’s diverticulum in a child: report of one case. Acta Paediatr Taiwan 44:41–43PubMed Lu CC, Huang FC, Lee SY, Huang HY (2003) Laparoscopy diagnosis and treatment excision of bleeding Meckel’s diverticulum in a child: report of one case. Acta Paediatr Taiwan 44:41–43PubMed
5.
go back to reference Grewal H, Sweat J, Vazquez WD (2004) Laparoscopic appendectomy in children can be done as a fast-track or same-day surgery. JSLS 8:151–154PubMed Grewal H, Sweat J, Vazquez WD (2004) Laparoscopic appendectomy in children can be done as a fast-track or same-day surgery. JSLS 8:151–154PubMed
6.
go back to reference Lee KH, Yeung CK, Tam YH, Liu KK (2000) The use of laparoscopy in the management of adnexal pathologies in children. ANZ J Surg 70:192–195CrossRef Lee KH, Yeung CK, Tam YH, Liu KK (2000) The use of laparoscopy in the management of adnexal pathologies in children. ANZ J Surg 70:192–195CrossRef
7.
go back to reference Chui CH, Ong LY, Chua JH (2007) “Chinese fan spread” distraction technique of laparoscopic reduction of intussusception. JSLS 11:238–241PubMed Chui CH, Ong LY, Chua JH (2007) “Chinese fan spread” distraction technique of laparoscopic reduction of intussusception. JSLS 11:238–241PubMed
8.
go back to reference Vane DW, West KW, Grosfeld JL (1987) Vitelline duct anomalies: experience with 217 childhood cases. Arch Surg 122:542–547PubMed Vane DW, West KW, Grosfeld JL (1987) Vitelline duct anomalies: experience with 217 childhood cases. Arch Surg 122:542–547PubMed
9.
go back to reference Sfakianakis GN, Conway JJ (1981) Detection of ectopicgastric mucosa in Meckel’s diverticulum and in other aberrations by scintigraphy: indications and methods: a 10-year experience. J Nucl Med 22:732–738PubMed Sfakianakis GN, Conway JJ (1981) Detection of ectopicgastric mucosa in Meckel’s diverticulum and in other aberrations by scintigraphy: indications and methods: a 10-year experience. J Nucl Med 22:732–738PubMed
10.
go back to reference Rerksuppaphol S, Hutson JM, Oliver MR (2004) Ranitidine-enhanced 99 m technetium pertechnetate imaging in children improves the sensitivity of identifying heterotopic gastric mucosa in Meckel’s diverticulum. Pediatr Surg Int 20:323–325PubMed Rerksuppaphol S, Hutson JM, Oliver MR (2004) Ranitidine-enhanced 99 m technetium pertechnetate imaging in children improves the sensitivity of identifying heterotopic gastric mucosa in Meckel’s diverticulum. Pediatr Surg Int 20:323–325PubMed
11.
go back to reference Lee KH, Yeung CK, Tam YH (2000) Laparoscopy for definitive diagnosis and treatment of gastrointestinal bleeding of obscure origin in children. J Pediatr Surg 35:1291–1293PubMedCrossRef Lee KH, Yeung CK, Tam YH (2000) Laparoscopy for definitive diagnosis and treatment of gastrointestinal bleeding of obscure origin in children. J Pediatr Surg 35:1291–1293PubMedCrossRef
12.
go back to reference Swaniker F, Soldes O, Hirschl RB (1999) The utility of technetium 99 m pertechnetate scintigraphy in the evaluation of patients with Meckel’s diverticulum. J Pediatr Surg 34:760–765PubMedCrossRef Swaniker F, Soldes O, Hirschl RB (1999) The utility of technetium 99 m pertechnetate scintigraphy in the evaluation of patients with Meckel’s diverticulum. J Pediatr Surg 34:760–765PubMedCrossRef
13.
go back to reference Sai Prasad TR, Chui CH, Singaporewalla FR (2007) Meckel’s diverticular complications in children: is laparoscopy the order of the day? Pediatr Surg Int 23:141–147PubMedCrossRef Sai Prasad TR, Chui CH, Singaporewalla FR (2007) Meckel’s diverticular complications in children: is laparoscopy the order of the day? Pediatr Surg Int 23:141–147PubMedCrossRef
14.
go back to reference Shalaby RY, Soliman SM, Fawy M (2005) Laparoscopic management of Meckel’s diverticulum in children. J Pediatr Surg 40:562–567PubMedCrossRef Shalaby RY, Soliman SM, Fawy M (2005) Laparoscopic management of Meckel’s diverticulum in children. J Pediatr Surg 40:562–567PubMedCrossRef
15.
go back to reference Sarli L, Costi R (2001) Laparoscopic resection of Meckel’s diverticulum: report of two cases. Surg Today 31:823–825PubMedCrossRef Sarli L, Costi R (2001) Laparoscopic resection of Meckel’s diverticulum: report of two cases. Surg Today 31:823–825PubMedCrossRef
16.
go back to reference Cheung ST, Lee KH, Yeung TH (2007) Minimally invasive approach in the management of childhood intussusception. ANZ J Surg 77:778–781PubMedCrossRef Cheung ST, Lee KH, Yeung TH (2007) Minimally invasive approach in the management of childhood intussusception. ANZ J Surg 77:778–781PubMedCrossRef
17.
go back to reference Varcoe RL, Wong SW, Taylor CF (2004) Diverticulectomy is inadequate treatment for short Meckel’s diverticulum with heterotopic mucosa. ANZ J Surg 74:869–872PubMedCrossRef Varcoe RL, Wong SW, Taylor CF (2004) Diverticulectomy is inadequate treatment for short Meckel’s diverticulum with heterotopic mucosa. ANZ J Surg 74:869–872PubMedCrossRef
18.
go back to reference Amoury RA, Snyder CL (1998) Meckel’s diverticulum. Pediatric surgery. Mosby, St. Louis pp 1173–1184 Amoury RA, Snyder CL (1998) Meckel’s diverticulum. Pediatric surgery. Mosby, St. Louis pp 1173–1184
Metadata
Title
Laparoscopic management of complicated Meckel’s diverticulum in children: a 10-year review
Authors
K. W. Chan
K. H. Lee
J. W. C. Mou
S. T. Cheung
Y. H. Tam
Publication date
01-06-2008
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 6/2008
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-008-9832-0

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