Meckel’s Diverticulum and Patent Vitello-Intestinal Duct in Children: A Review of 11 Years of Experience with 46 Cases 689-693
Correspondence
Dr Rajendra K Ghritlaharey
Associate Professor, Department of Paediatric Surgery,
Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal,
Madhya Pradesh 462 001 (India)
Phone No: + 91-755 - 4050571(R), 4050261(O)
E-mail: drrajendrak1@rediffmail.com
Aim: The aim of this study was to review the management of symptomatic Meckel’s diverticulum and patent vitello-intestinal duct (PVID) in children.
Patients and Methods: This retrospective study included 46 children (39 boys and 7 girls) who underwent exploratory laparotomy for the management of symptomatic Meckel’s diverticulum and PVID between Jan 1, 2000 to Dec 31, 2010.
Results: During last 11 years, 46 (39 boys and 7 girls) children were treated for symptomatic Meckel’s diverticulum and PVID under 12 years: 23 (50%) were infants, 5 (10.86%) were 1 to 5 years and 18 (39.13%) were 6 to 12 years of age. Majority n=28 (60.86%) presented with intestinal obstruction (including 5 cases of intussusception and 6 cases of PVID), followed by n=6 (13.04%) as perforation peritonitis, n=4 (8.69%) as lower gastrointestinal bleeding / melena, n=4 (8.69%) as umbilical discharge (PVID) and n=4 (8.69%) as incidental findings duringlaparotomy for others. Findings at laparotomy in order of frequency were: Meckel’s diverticulum with gangrenous bowel (n = 13), PVID (n=10) 4 had prolapsed ileum and 3 of them were gangrenous, Meckel’s diverticulum with bands (n=9), perforated Meckel’s diverticulum (n=6), diverticulitis / bleeding (n=4) and normal Meckel’s diverticulum / incidental findings (n=4). The surgical procedures done in order of frequency were: segmental resection of ileum containing Meckel’s diverticulum and ileo-ileal anastomosis n=25 (54.34%), diverticulectomy / wedge resection n=19 (41.30%), segmental resection and ileo-ascending anastomosis n=1 (2.17%) and segmental resection with an ileostomy n=1 (2.17%). The mortality following laparotomy done for Meckel’s and PVID was n= 4 (8.69%).
Conclusions: Symptomatic Meckel’s diverticulum and PVID is also an important cause of acute abdomen / intestinal obstruction in infants and children and delay in seeking treatment is not only associated with morbidity but prone to mortality as well.