Predictive model of heterotopy in Meckel's diverticulum in children

Abstract

Background:The presence of heterotopic tissue in Meckel's diverticulum (MD) increases the incidence of future complications. Based on this concept, this study aimed to detect clinical and morphological parameters able to predict the probability of heterotopy in incidentally discovered uncomplicated MD and to develop a risk-based classification tool. Methods: The clinical records of 146 patients who underwent MD resection were reviewed. MD complications (bleeding, inflammation, perforation or involvement in pathological processes such as intussusception) and MD dimensions (width, length and the product width × length) were evaluated in association with heterotopy. Regression analysis was used to explore the discrete effect of clinically relevant parameters, which were subsequently combined in a Classification and Regression Tree. Results: The probability of heterotopy was higher in complicated MDs. The width of the base of the MD and the product width × length were also significant predictors of heterotopy. A stepwise combination (Classification and Regression Tree model) of (i) uncomplicated macroscopic presentation, (ii) width <2.5 cm, (iii) age <10 years and (iv) product width × length <4 cm 2 resulted in a null probability of heterotopy in our study group. Conclusion: The combination of MD-related clinical and morphological parameters using advanced statistical tools may assist in estimating the probability of heterotopy. This may be applied in incidentally discovered uncomplicated MDs during abdominal surgery for other morbidities. Prospective studies are required to confirm our findings and test the practical usefulness of the classification tool developed here. © 2019 Royal Australasian College of Surgeons ANZ J Surg 89 (2019) E241-E245ANZJSurg.com

Individualized Treatment of Inguinal Hernia in Children

“…It is typically found at the antimesenteric border of the ileum, usually located from 30 to 90 cm from the ileocecal valve, presenting occasionally ectopic gastric or pancreatic mucosa, and remains asymptomatic in 91-96%. When symptomatic, it appears frequently as hemorrhage, perforation, inflammation, and obstruction [16]. Involvement of a MD in a hernia is known as Littré's hernia (LH) [17].…”

Criança com intussuscepção e divertículo de Meckel: relato de caso

“…Muitas vezes é um achado incidental na laparotomia ou laparoscopia (Chen et al, 2018). E há envolvimento em processos patológicos como intussuscepção (Sinopidis et al, 2019).…”