Meckel’s Diverticulum in Children: A Monocentric Experience and Mini-Review of Literature

Nissen, Matthias; Sander, Volker; Rogge, Phillip; Alrefai, Mohamad; Tröbs, Ralf-Bodo

doi:10.3390/children9010035

Cited by 3 publications

(4 citation statements)

References 26 publications

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“…Our data are globally concordant with the literature, even if 11% of MD were found beyond 60cm, suggesting the search of MD extended at least up 100 cm. At a variant of the literature [24,28], we could not demonstrate a correlation between age and distance from the ileocecal valve.…”

Section: Discussioncontrasting

confidence: 76%

“…Furthermore, our data showed no age differences comparing patients with intestinal bleeding and occlusion. On the contrary, it has been reported a younger mean age in children with intestinal obstruction, probably caused by the increased peristalsis due to the greater number of Auerbach plexus fibers present in young children [24]. The possibility to find an ectopic mucosa in the symptomatic MD is reported to be as high as 65-90% [25].…”

Section: Discussionmentioning

confidence: 99%

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Meckel’s Diverticulum Does not fit the Rule of Two: A Bicentric Experience

2022

J Surg

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Introduction: Meckel's Diverticulum (MD) is the most common gastro-intestinal congenital malformation. The Rule of Two is largely diffused to describe the characteristics of MD, but in a consistent number of cases, clinic and histology do not fit into the rules. The experience of two referral centers is reported. Methods:The Rule of Two includes: 2% prevalence, male/female ratio 2:1, <2 years of age, location within 2 feet (60 cm) from the Ileocecal Valve (ICV), 2 inches' length (5 cm), 2 types of ectopic mucosa. Patients with MD admitted between 2010 and February 2022 were analyzed. Appendectomies, performed in the same period, were considered as the reference population. Data on prevalence, gender, age, position along the intestine, MD length, histology were analyzed.Results: Seventy-three patients were identified, of whom 43 symptomatic (59%). Appendectomies were 2289, the prevalence was 2.9%. Male/female ratio was 2.65; 8.5 in case of gastrointestinal bleeding. Mean age at onset 5.48 ± 4.34 years (range 0.08-14): 60.5%>2-year-old. Mean distance from IVC 45.10 ± 16.66 cm: 11% were >2 feet. Mean MD length 3.13cm ± 1.49. Ectopic tissues, found in 19, were all gastric mucosa except for 1 case of gastric-pancreatic mucosa. Conclusions:The diagnosis of MD should be included throughout all the pediatric age and the intestinal examination extended until 100 cm from IVC, especially in older children. According to our results, the Rule of Two seems too limited to describe the characteristics of MD.

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Section: Discussioncontrasting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Meckel’s Diverticulum Does not fit the Rule of Two: A Bicentric Experience

2022

J Surg

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“…Meckel's diverticulum (MD) is a saccular formation present in the lower part of the intestine, and it is considered one of the most common congenital anomalies of the gastrointestinal tract [1,2]. It results from embryologic closure failure of the omphalomesenteric duct [3]. The protrusion of MD in a hernia sac is called a Littre hernia [2].…”

Section: Introductionmentioning

confidence: 99%

Management of Littre Hernia—Case Report and Systematic Review of Case Reports

Răcăreanu

Preda

et al. 2023

JCM

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Littre hernia is a rare type of hernia in which a Meckel diverticulum is found in the hernia sac. Given the rare nature of this disease, little data on demographics and surgical management exists. In this article, we provide a case report of a strangulated inguinal Littre hernia and perform a systematic review of the literature. The PubMed database was searched on 5 March 2022, and all cases of Littre hernia in adults that had English abstracts or full-text were analyzed. Our primary objective was to evaluate the surgical management and outcomes of this particular type of hernia, and our secondary objectives were to assess demographic characteristics, presentation particularities, and recurrence rates. We identified 89 articles with 98 cases, including our own. Results show a high prevalence of complications described intraoperatively, with strangulation being present in up to 38.46% of patients. The laparoscopic approach was utilized in patients with femoral, inguinal, and umbilical hernias. The most commonly performed type of resection was MD resection, followed by bowel resection, while a minority of cases (5.48%) remained unresected. Mesh repair was more frequently performed in patients with MD resection. A mortality rate of 8.7% in patients who underwent bowel resection was found. A relatively high number of reports of ectopic tissue (21.21%), ulceration (12.12%), and tumors (9.09%) were found. The average follow-up was 19.5 ± 10.29 months, with no hernia recurrence. In conclusion, most cases are admitted in an emergency setting, and intestinal obstruction is frequently associated. A minimally invasive approach can be an option even for complicated hernias. MD resection or bowel resection is usually employed, depending on the extent of ischemic lesions. Patients undergoing bowel resection may be prone to worse outcomes.

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“…Dependendo da extensão e do local de desintegração e absorção, são várias as anomalias que podem resultar, incluindo OMD patente, cordões fibrosos do umbigo ao íleo, seio do ducto onfalomesentérico (umbilical) ou cisto em caso de persistência distal. No entanto, sua persistência na parte proximal constitui o representante mais comumente observado de anomalias do ducto vitelino, que é o divertículo de Meckel (Nissen et al, 2022).…”

Section: Introductionunclassified

Criança com intussuscepção e divertículo de Meckel: relato de caso

Júnior¹,

Rodriguez²

2022

Braz. J. Hea. Rev.

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O divertículo de Meckel é uma malformação congênita do trato gastrointestinal, sendo a mais frequente delas.Normalmente é assintomático, porém pode causar complicações, especialmente em jovens. Suas principais complicações incluem sangramento gastrointestinal, obstrução intestinal, perfuração e inflamação, podendo se envolver em processos patológicos como a intussuscepção, que resulta do encarceramento do segmento intestinal a montante no segmento a jusante. Esse estudo traz um relato de caso de um paciente pediátrico masculino, com três meses e quatro dias de idade, com diagnóstico pré-operatório de obstrução intestinal, encaminhado para uma laparotomia exploratória. Durante o procedimento cirúrgico foi diagnosticado o divertículo de Meckel associado a uma intussuscepção intestinal, sendo necessária uma colectomia / enterectomia a nível de íleo distal. Em casos como esse, a cirurgia continua sendo o tratamento de escolha, porém quando executada com a técnica adequada e cuidados pós-cirúrgicos eficazes transcorre sem maiores complicações.

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Meckel’s Diverticulum in Children: A Monocentric Experience and Mini-Review of Literature

Cited by 3 publications

References 26 publications

Meckel’s Diverticulum Does not fit the Rule of Two: A Bicentric Experience

Meckel’s Diverticulum Does not fit the Rule of Two: A Bicentric Experience

Management of Littre Hernia—Case Report and Systematic Review of Case Reports

Criança com intussuscepção e divertículo de Meckel: relato de caso

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