title: Correlation of gastric heterotopia and Meckel's diverticular bleeding in children: a unique association.
abstract: OBJECTIVE
  Meckel's diverticular bleeding is the commonest cause of major gastrointestinal (GI) haemorrhage in children. We hypothesise that gastric heterotopia (GH) is associated with increased risk of bleeding and, therefore, may affect initial management.
  
  
  METHODS
  Paediatric patients with histological diagnosis of Meckel's diverticulum (MD) following diverticulectomy from 1995 to 2011 were reviewed retrospectively, focusing on histological correlation to bleeding. GH identified on histology was regarded as GH+, and where GH was not found was regarded as GH-. Two-tailed Chi-square test and Fisher's exact test were used, p < 0.05 was statistically significant.
  
  
  RESULTS
  Thirty-nine patients underwent Meckel's diverticulectomy. The number of patients with GH+, GH-, and bowel necrosis were 21, 15, and 3. Eighteen children with MD had GI bleeding. GI bleeding was more commonly associated with GH+ (14/21) than GH- (4/15) (67 vs 27 %, p = 0.02). Further analysis revealed all four GH- bleeding originated from other sources than the MD. GH+ had no significant association with other presentations. GH+ was present in 8/8 (100 %) positive Meckel's scans and 2/5 (40 %) negative scans. Meckel's scan had a sensitivity of 8/10 (80 %), and specificity of 3/3 (100 %).
  
  
  CONCLUSIONS
  This study confirmed that GH positive MD is a unique entity presenting typically with GI bleeding.
authors: Department of Paediatric Surgery, Level 3, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK, ashwath@doctors.org.uk.
authors: A
authors: A
authors: Bandi
authors: Y W
authors: YW
authors: Tan
authors: T
authors: T
authors: Tsang
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002828:Choristoma / Q000150:complications*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005260:Female; D005753:Gastric Mucosa; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008467:Meckel Diverticulum / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity