Meckel’s Diverticulum: Factors Associated with Clinical Manifestations

Abstract

Objectives. The purpose of this study was to investigate the clinical features of Meckel's diverticula at different ages, genders, and pathology in order to serve as a reminder to clinicians when evaluating potential cases and to help obtain an early diagnosis. Methods. We collected information of patients with Meckel's diverticulum diagnosed at Mackay Memorial Hospital in Taiwan from 1984 to 2009. After performing a thorough review of their charts, the clinical features of the Meckel's diverticula were analyzed according to age groups, gender, and pathology. Result. A total of 126 patients, with 90 males and 36 females, were enrolled in this study. Seventy-five patients were symptomatic and 51 Meckel's diverticula were found incidentally during surgery for other diseases. Among symptomatic patients, 39% of pediatric patients and 5% of adult patients had intestinal hemorrhage. Twenty-eight percent of pediatric patients and 67% of adult patients had inflammation of Meckel's diverticulum. Forty-six percent of males and 16% of females had inflammation. Conversely, 27% of males and 58% percent of females had intestinal obstruction. When Meckel's diverticulum had ectopic gastric mucosa, it tended to cause intestinal hemorrhage when the patient is young. Conclusions. Age, gender, and pathology affect the clinical presentations of Meckel's diverticula.

Meckel’s diverticulum: Ten years’ experience

“…Compared with the literature, the rate of ectopic mucosa according to histopathological evaluation is simi-lar to our study (2). There was gastric mucosa in eight patients (89%), and pancreatic tissue in one patient (11%).…”

“…It contains all layers of the normal bowel and has been shown to contain ectopic tissues such as gastric or pancreatic tissue in about 50% of cases. Meckel's diverticulum cases are generally asymptomatic, and complications and symptoms are more common in patients with ectopic tissue (1)(2)(3). The male to female ratio in Meckel's diverticulum is one, with a male dominance in symptomatic cases.…”

“…Patients often present with complications such as bleeding, bowel obstruction, fistula and intussusception (2,(4)(5)(6). Lifelong complication rates are reported as 4-34% (1)(2)(3)(4), and complications are more common in patients younger than 2 years of age (3,7). Complication rate is reported to decrease with advancing age (8).…”

Obscure Gastrointestinal Bleeding Due to a Small Intestinal Gastrointestinal Stromal Tumor in a Young Adult

“…Meckel's diverticulum is the most common congenital anomaly of the GI tract, with an incidence of 2–4% in the general population. Meckel's diverticulum occurs twice as often in men than in women, and acute diverticulitis can occur at any age, but the incidence peaks in children [15, 16]. Meckel's diverticulum is always located within 1 m of the oral side of the ileocecal valve and straying ectopic stomach tissue is the key pathological feature in 27% of patients with this disease [16].…”

“…Meckel's diverticulum occurs twice as often in men than in women, and acute diverticulitis can occur at any age, but the incidence peaks in children [15, 16]. Meckel's diverticulum is always located within 1 m of the oral side of the ileocecal valve and straying ectopic stomach tissue is the key pathological feature in 27% of patients with this disease [16]. The specimen resected from our patient macroscopically resembled diverticulitis, but it was not obtained from a location within 1 m from the oral side of the ileocecal valve.…”