All issues > Volume 45(4); 2002

Original Article

J Korean Pediatr Soc. 2002;45(4):466-472. Published online April 15, 2002.

A Clinical Manifestation of Meckel's Diverticulum

Jin Beom JB Lee¹, Yong Soon YS Lee², Eun Sun ES Yoo¹, Hae Soon HS Kim¹, Se Jeong SJ Son¹, Eun Ae EA Park¹, Seung Joo SJ Lee¹, Sun Hee SH Sung³, Jeong Wan JW Seo¹

¹Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
²Department of Pediatrics, Dongbu Municipal Hospital, Seoul, Korea
³Department of Pathology, College of Medicine, Ewha Womans University, Seoul, Korea

Correspondence Jeong Wan JW Seo ,Email: jwseo@mm.ewha.ac.kr

Abstract

Purpose
: The diagnosis of Meckel's diverticulum is difficult and delayed because it presents with various clinical symptoms. We evaluated clinical, imaging and pathologic findings of Meckel's diverticulum to facilitate detection of Meckel's diverticulum in children.
Methods
: Review of clinical, imaging, surgical and pathological findings in 10 children aged 7 days to 14 years with Meckel's diverticulum during an 8-year period, 1993-2001, at Ewha Womans University Hospital was undertaken.
Results
: The male to female ratio was 2.3 : 1. The chief complaint was painless lower gastrointestinal(GI) bleeding; others were abdominal pain, abdominal distention and vomiting, in order of frequency. The diagonsis before surgery were Meckel's diverticulum in 5 patients, non-reducible intussusception in 3 patients and intestinal obstruction in 2 patients. The diverticulum was located between 35 cm to 70 cm proximal to the ileocecal valve. The length of the diverticulum ranged from 4 cm to 12 cm and 80% of it was within 5 cm. A Meckel scan(99mTc-pertechnetate scintigraphy) after cimetidine administration was done in 6 cases. All 5 cases that presented with lower GI bleeding had ectopic gastric mucosa confirmed on pathology. Out of 5 cases of ectopic gastric mucosa, only 4 cases were positive on the Meckel's scan.
Conclusion
: In cases of unexplained GI bleeding, obstruction, or inflammation diagnostic workup should be carried out to rule out Meckel's diverticulum. Laparoscopy, high resolution ultrasonography and computed tomography of the abdomen may be indicated in the assessment of pediatric patient with lower GI bleeding, especially in patients with suspected bleeding from Meckel's diverticulum showing negative Meckel's scan.

Keywords :Meckel's diverticulum, Meckel's scan, Children