Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang, China.
Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China.
Eur J Radiol. 2022 Dec;157:110611. doi: 10.1016/j.ejrad.2022.110611. Epub 2022 Nov 14.
Inverted Meckel's diverticulum (IMD) is a well-established but rare disease. This study aimed to summarize the radiological and clinical characteristics of IMD, and correlates its radiological and surgical findings to obtain an accurate early preoperative diagnosis.
This is a retrospective study included IMD patients from a large children's medical center in China, between January 2009 and March 2022. We reviewed demographic data, clinical manifestations, preoperative examinations, surgical findings, histopathological results, and outcomes.
Twenty-three cases with IMD (14 male patients [60.9%]; median age, 6.7 years; age range, 9 months to 13 years) were retrospectively reviewed over a period of 13 years. The typical clinical manifestations of IMD included abdominal pain, vomiting, and abdominal tenderness. The most commonly used imaging modalities were abdominal ultrasound and computed tomography. This is the first case series on pediatric IMD, that describes the clinical process of IMD, proposes clinical phases of IMD, and first summarizes the radiological findings characteristic of each clinical phase.
The clinical process of IMD can be divided into four phases (intussuscepted Meckel's diverticulum [MD], inverting MD, inverted MD, intussusception secondary to IMD). Patients in different clinical phases present with various radiological features. Mastering the radiological and clinical characteristics of each phase of IMD can aid in its early diagnosis and timely operative intervention, thus avoiding unnecessary intestinal necrosis and resection.
倒置 Meckel 憩室(IMD)是一种已被充分证实但罕见的疾病。本研究旨在总结 IMD 的放射学和临床特征,并将其放射学和手术发现进行关联,以获得准确的术前早期诊断。
这是一项在中国一家大型儿童医院进行的 IMD 患者的回顾性研究,研究时间为 2009 年 1 月至 2022 年 3 月。我们回顾了患者的人口统计学数据、临床表现、术前检查、手术发现、组织病理学结果和结局。
回顾性分析了 13 年间的 23 例 IMD 患者(14 例男性[60.9%];中位年龄 6.7 岁;年龄范围 9 个月至 13 岁)。IMD 的典型临床表现包括腹痛、呕吐和腹部压痛。最常用的影像学检查方法是腹部超声和计算机断层扫描。这是首例关于小儿 IMD 的病例系列研究,描述了 IMD 的临床过程,提出了 IMD 的临床阶段,并首次总结了每个临床阶段的放射学特征。
IMD 的临床过程可分为四个阶段(肠套叠 Meckel 憩室[MD]、倒置 MD、倒置 MD、IMD 继发肠套叠)。处于不同临床阶段的患者表现出不同的放射学特征。掌握 IMD 各阶段的放射学和临床特征有助于早期诊断和及时手术干预,从而避免不必要的肠坏死和切除。