Optimizing surgical resection of the bleeding Meckel diverticulum in children
Autor: | Jamie R. Robinson, Adam S. Brinkman, Harold N. Lovvorn, Hernan Correa |
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Rok vydání: | 2016 |
Předmět: |
Surgical resection
Male medicine.medical_specialty Gastrointestinal bleeding Mucosal ulceration Adolescent digestive system Article Tertiary Care Centers 03 medical and health sciences 0302 clinical medicine Gastric mucosa medicine Humans Child Pathological Digestive System Surgical Procedures Retrospective Studies business.industry Diagnostic Tests Routine General Medicine medicine.disease digestive system diseases Surgery Gastric heterotopia Meckel Diverticulum medicine.anatomical_structure Treatment Outcome Gastric Mucosa 030220 oncology & carcinogenesis Child Preschool Pediatrics Perinatology and Child Health 030211 gastroenterology & hepatology Female business Gastrointestinal Hemorrhage Diverticulum |
Zdroj: | Journal of pediatric surgery. 52(10) |
ISSN: | 1531-5037 |
Popis: | Purpose Meckel diverticula containing gastric heterotopia predispose to local hyperacidity, mucosal ulceration, and gastrointestinal bleeding in children. Eradication of acid-producing oxyntic cells is performed by either of two surgical methods: segmental enterectomy including the diverticulum or diverticulectomy only. Methods Retrospective review of all children having surgical resection of a Meckel diverticulum at a tertiary-referral children's hospital from 2002 to 2016 was performed. Demographic data, surgical method, pathological specimens, and outcomes were evaluated. Results 102 children underwent surgical resection of a Meckel diverticulum during the study period. 27 (26.5%) children presented with bleeding, of which 16 (59%) had diverticulectomy only, and 11 (41%) had segmental ileal resection. All Meckel diverticula in children presenting with bleeding contained gastric heterotopia, and resection margins were free of gastric mucosa. Histologically, 19 specimens showed microscopic features of ulceration, on average 2.95mm (SD 4.49) from the nearest gastric mucosa (range: 0–16mm). Mean length of hospitalization after ileal resection was 4.0days (SD 1.2) compared to 1.6days (SD 0.9) for diverticulectomy only (p Conclusion In the operative management of children having a bleeding Meckel diverticulum, diverticulectomy-only completely eradicates gastric heterotopia without increased risk of continued bleeding or complications and significantly shortens hospitalization. Level of evidence Treatment Study: Level III. |
Databáze: | OpenAIRE |
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