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Published in: World Journal of Surgery 11/2018

01-11-2018 | Original Scientific Report

Meckel’s Diverticulum in Children—Parameters Predicting the Presence of Gastric Heterotopia

Authors: Ivana Slívová, Zuzana Vávrová, Hana Tomášková, Okaikor Okantey, Igor Penka, Peter Ihnát

Published in: World Journal of Surgery | Issue 11/2018

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Abstract

Background

The presence of gastric ectopic mucosa in Meckel’s diverticulum is associated with a higher risk of development of complications. The aim of the present study was to investigate which demographic/clinical parameters predict the presence of gastric heterotopia in Meckel’s diverticulum.

Methods

This was a retrospective cohort study conducted in a single institution (University Hospital Ostrava, Czech republic). All children who underwent laparoscopic/open resection of Meckel’s diverticulum within a 20-year study period were included in the study.

Results

In total, 88 pediatric patients underwent analysis. The mean age of the children was 4.6 ± 4.73 years; the male–female ratio was approximately 2:1. There were 50 (56.8%) patients with asymptomatic Meckel’s diverticulum in our study group. Laparoscopic resection was performed in 24 (27.3%) patients; segmental bowel resection through laparotomy was performed in 13 (14.8%) patients. Gastric heterotopia was found in 39 (44.3%) patients; resection margins of all patients were clear of gastric heterotopia. No correlation was found between the presence of gastric heterotopia and the following parameters: age, gender, maternal age, prematurity, low birth weight, perinatal asphyxia, distance from Bauhin’s valve and length of Meckel’s diverticulum. The width of the diverticulum base was significantly higher in patients with gastric heterotopia (2.1 ± 0.57 vs. 1.2 ± 0.41 cm; p < 0.001).

Conclusions

According to the study outcomes, the width of the diverticulum base seems to be a significant predictive factor associated with the presence of gastric heterotopia in Meckel’s diverticulum. The laparoscopic/open resection of asymptomatic MD with a wide base should therefore be recommended.
Literature
1.
go back to reference Francis A, Kantarovich D, Khoshnam N et al (2016) Pediatric Meckel’s diverticulum: report of 208 cases and review of the literature. Fetal Pediatr Pathol 35(3):199–206CrossRef Francis A, Kantarovich D, Khoshnam N et al (2016) Pediatric Meckel’s diverticulum: report of 208 cases and review of the literature. Fetal Pediatr Pathol 35(3):199–206CrossRef
2.
go back to reference Çelebi S (2017) Male predominance in Meckel’s diverticulum: a hyperacidity hypotheses. Med Hypotheses 104:54–57CrossRef Çelebi S (2017) Male predominance in Meckel’s diverticulum: a hyperacidity hypotheses. Med Hypotheses 104:54–57CrossRef
3.
go back to reference Cserni G (1996) Gastric pathology in Meckel’s diverticulum. Review of cases resected between 1965 and 1995. Am J Clin Pathol 106(6):782–785CrossRef Cserni G (1996) Gastric pathology in Meckel’s diverticulum. Review of cases resected between 1965 and 1995. Am J Clin Pathol 106(6):782–785CrossRef
4.
go back to reference Sagar J, Kumar V, Shah DK (2006) Meckel’s diverticulum: a systematic review. J R Soc Med 99:501–505CrossRef Sagar J, Kumar V, Shah DK (2006) Meckel’s diverticulum: a systematic review. J R Soc Med 99:501–505CrossRef
5.
go back to reference Robinson JR, Correa H, Brinkman AS et al (2017) Optimizing surgical resection of the bleeding Meckel diverticulum in children. J Pediatr Surg 52(10):1610–1615CrossRef Robinson JR, Correa H, Brinkman AS et al (2017) Optimizing surgical resection of the bleeding Meckel diverticulum in children. J Pediatr Surg 52(10):1610–1615CrossRef
6.
go back to reference Stone PA, Hofeldt MJ, Campbell JE et al (2004) Meckel diverticulum: ten-year experience in adults. South Med J 97(11):1038–1041CrossRef Stone PA, Hofeldt MJ, Campbell JE et al (2004) Meckel diverticulum: ten-year experience in adults. South Med J 97(11):1038–1041CrossRef
7.
go back to reference Ergün O, Celik A, Akarca US et al (2002) Does colonization of Helicobacter pylori in the heterotopic gastric mucosa play a role in bleeding of Meckel’s diverticulum? J Ped Surg 37(11):1540–1542CrossRef Ergün O, Celik A, Akarca US et al (2002) Does colonization of Helicobacter pylori in the heterotopic gastric mucosa play a role in bleeding of Meckel’s diverticulum? J Ped Surg 37(11):1540–1542CrossRef
8.
go back to reference Groebli Y, Berlin D, Morel P (2001) Meckel’s diverticulum in adults: retrospective analysis of 119 cases and historical review. Eur J Surg 167:518–524CrossRef Groebli Y, Berlin D, Morel P (2001) Meckel’s diverticulum in adults: retrospective analysis of 119 cases and historical review. Eur J Surg 167:518–524CrossRef
9.
go back to reference Park JJ, Wolff BG, Tollefson MK et al (2005) Meckel diverticulum: the Mayo clinic experience with 1476 patients (1950–2002). Ann Surg 241:529–533CrossRef Park JJ, Wolff BG, Tollefson MK et al (2005) Meckel diverticulum: the Mayo clinic experience with 1476 patients (1950–2002). Ann Surg 241:529–533CrossRef
10.
go back to reference Ruscher KA, Fisher JN, Hughes CD et al (2011) National trends in the surgical management of Meckel’s diverticulum. J Pediatr Surg 46:893–896CrossRef Ruscher KA, Fisher JN, Hughes CD et al (2011) National trends in the surgical management of Meckel’s diverticulum. J Pediatr Surg 46:893–896CrossRef
11.
go back to reference Zani A, Eaton S, Rees CM et al (2008) Incidentally detected Meckel diverticulum: to resect or not to resect? Ann Surg 247:276–281CrossRef Zani A, Eaton S, Rees CM et al (2008) Incidentally detected Meckel diverticulum: to resect or not to resect? Ann Surg 247:276–281CrossRef
12.
go back to reference Lequet J, Menahem B, Alves A et al (2017) Meckel’s diverticulum in the adult. J Visc Surg 154(4):253–259CrossRef Lequet J, Menahem B, Alves A et al (2017) Meckel’s diverticulum in the adult. J Visc Surg 154(4):253–259CrossRef
13.
go back to reference Meckel JF (1809) Über die Divertikel am Darmkanal. Archiv für die Physiologie (Halle) 9:421–453 Meckel JF (1809) Über die Divertikel am Darmkanal. Archiv für die Physiologie (Halle) 9:421–453
14.
go back to reference Dumper J, Mackenzie S, Mitchell P et al (2006) Complications of Meckel’s diverticula in adults. Can J Surg 49:353–357PubMedPubMedCentral Dumper J, Mackenzie S, Mitchell P et al (2006) Complications of Meckel’s diverticula in adults. Can J Surg 49:353–357PubMedPubMedCentral
15.
go back to reference Cullen JJ, Kelly KA, Moir CR et al (1994) Surgical management of Meckel’s diverticulum. An epidemiologic, population-based study. Ann Surg 220:564–568CrossRef Cullen JJ, Kelly KA, Moir CR et al (1994) Surgical management of Meckel’s diverticulum. An epidemiologic, population-based study. Ann Surg 220:564–568CrossRef
17.
go back to reference Soltero MA, Bill AH (1976) The natural history of Meckel’s diverticulum and its relation to incidental removal. Am J Surg 132:168–173CrossRef Soltero MA, Bill AH (1976) The natural history of Meckel’s diverticulum and its relation to incidental removal. Am J Surg 132:168–173CrossRef
18.
go back to reference Mackey WC, Dineen P (1983) A fifty year experience with Meckel’s diverticulum. Surg Gynecol Obstet 156:56–64PubMed Mackey WC, Dineen P (1983) A fifty year experience with Meckel’s diverticulum. Surg Gynecol Obstet 156:56–64PubMed
19.
go back to reference Blaser MJ (1987) Gastric campylobacter-like organisms, gastritis and peptic ulcer disease. Gastroenterology 93:371–383CrossRef Blaser MJ (1987) Gastric campylobacter-like organisms, gastritis and peptic ulcer disease. Gastroenterology 93:371–383CrossRef
20.
go back to reference Lee KH, Yeung CK, Tam YH et al (2000) Laparoscopy for definitive diagnosis and treatment of gastrointestinal bleeding of obscure origin in children. J Pediatric Surg 35(9):1291–1293CrossRef Lee KH, Yeung CK, Tam YH et al (2000) Laparoscopy for definitive diagnosis and treatment of gastrointestinal bleeding of obscure origin in children. J Pediatric Surg 35(9):1291–1293CrossRef
21.
go back to reference Chan KW, Lee KH, Mou JW et al (2008) Laparoscopic management of complicated Meckel’s diverticulum in children: a 10-year review. Surg Endosc 22(6):1509–1512CrossRef Chan KW, Lee KH, Mou JW et al (2008) Laparoscopic management of complicated Meckel’s diverticulum in children: a 10-year review. Surg Endosc 22(6):1509–1512CrossRef
22.
go back to reference Mukai M, Takamatsu H, Noguchi H et al (2002) Does the external appearance of a Meckel’s diverticulum assist in choice of the laparoscopic procedure? Pediatr Surg Int 18(4):231–233CrossRef Mukai M, Takamatsu H, Noguchi H et al (2002) Does the external appearance of a Meckel’s diverticulum assist in choice of the laparoscopic procedure? Pediatr Surg Int 18(4):231–233CrossRef
23.
go back to reference Palanivelu C, Rangarajan M, Senthilkumar R et al (2008) Laparoscopic management of symptomatic Meckel’s diverticulum. JSLS 12(1):66–70PubMedPubMedCentral Palanivelu C, Rangarajan M, Senthilkumar R et al (2008) Laparoscopic management of symptomatic Meckel’s diverticulum. JSLS 12(1):66–70PubMedPubMedCentral
Metadata
Title
Meckel’s Diverticulum in Children—Parameters Predicting the Presence of Gastric Heterotopia
Authors
Ivana Slívová
Zuzana Vávrová
Hana Tomášková
Okaikor Okantey
Igor Penka
Peter Ihnát
Publication date
01-11-2018
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 11/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-018-4664-0

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