Huang Chen-Chuan, Lai Ming-Wei, Hwang Fang-Ming, Yeh Yu-Chen, Chen Shih-Yen, Kong Man-Shan, Lai Jin-Yao, Chen Jeng-Chang, Ming Yung-Ching
Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Pediatr Neonatol. 2014 Oct;55(5):369-75. doi: 10.1016/j.pedneo.2013.12.005. Epub 2014 Mar 28.
Our objective was to analyze demographics and characteristics of Meckel's diverticulum with different manifestations in pediatric patients.
This is a retrospective study in children with symptomatic Meckel's diverticulum who underwent resection between September 1998 and October 2010. The diagnosis was confirmed by surgery and pathology. Demographic characteristics, manifestations, Meckel's scan results, surgical and histological findings were analyzed.
One hundred symptomatic Meckel's diverticula were identified in 74 boys and 26 girls aged from one day to 18 years old over 13 years. Depending on whether or not obstruction occurred, the patients were classified into two categories. Each category was further subdivided into two diagnostic groups: 17 intussusception and 24 non-intussusception bowel obstruction in the obstructive category and 44 gastrointestinal bleeding and 15 diverticulitis and/or perforation in the non-obstructive category. The sex discrepancy was higher in the non-obstructive category than in the obstructive category (male-to-female, 4.36 vs. 1.73, p < 0.05). Forty-one of 44 patients with gastrointestinal bleeding underwent a Meckel's scan with a high positive rate (92.7%). The ectopic tissues were identified in 73 patients and included 61 gastric type, two pancreatic type and 10 mixed type. Ectopic tissues were more prevalent in non-obstructive category (p < 0.05) with ectopic gastric tissue even more pronounced (p < 0.01). Ectopic pancreatic tissue was significantly more prevalent in intussusception (p < 0.01). Laparoscopic surgery was performed more frequently in Meckel's diverticulum with non-obstructive symptoms (p < 0.001).
Diverse presentations in pediatric Meckel's diverticulum are affected by different ectopic tissue types and male sex. Laparoscopic surgery is widely used for children with non-obstructive symptoms.
我们的目的是分析小儿患者中不同表现形式的梅克尔憩室的人口统计学特征和特点。
这是一项对1998年9月至2010年10月间接受手术切除的有症状梅克尔憩室患儿的回顾性研究。诊断通过手术和病理得以证实。对人口统计学特征、表现、梅克尔扫描结果、手术及组织学发现进行了分析。
在13年期间，共识别出100个有症状的梅克尔憩室，患者年龄从1天至18岁，其中男孩74例，女孩26例。根据是否发生梗阻，将患者分为两类。每类再进一步细分为两个诊断组：梗阻组中有17例肠套叠和24例非肠套叠性肠梗阻，非梗阻组中有44例胃肠道出血和15例憩室炎和/或穿孔。非梗阻组的性别差异高于梗阻组（男女性别比，4.36比1.73，p<0.05）。44例胃肠道出血患者中有41例进行了梅克尔扫描，阳性率较高（92.7%）。73例患者发现异位组织，其中61例为胃型，2例为胰腺型，10例为混合型。异位组织在非梗阻组中更为常见（p<0.05），异位胃组织更为明显（p<0.01）。异位胰腺组织在肠套叠中显著更常见（p<0.01）。有非梗阻症状的梅克尔憩室患者更常进行腹腔镜手术（p<0.001）。
小儿梅克尔憩室的不同表现受不同异位组织类型和男性性别的影响。腹腔镜手术广泛应用于有非梗阻症状的儿童。
