title: Diverse presentations in pediatric Meckel's diverticulum: a review of 100 cases.
abstract: BACKGROUND
  Our objective was to analyze demographics and characteristics of Meckel's diverticulum with different manifestations in pediatric patients.
  
  
  METHODS
  This is a retrospective study in children with symptomatic Meckel's diverticulum who underwent resection between September 1998 and October 2010. The diagnosis was confirmed by surgery and pathology. Demographic characteristics, manifestations, Meckel's scan results, surgical and histological findings were analyzed.
  
  
  RESULTS
  One hundred symptomatic Meckel's diverticula were identified in 74 boys and 26 girls aged from one day to 18 years old over 13 years. Depending on whether or not obstruction occurred, the patients were classified into two categories. Each category was further subdivided into two diagnostic groups: 17 intussusception and 24 non-intussusception bowel obstruction in the obstructive category and 44 gastrointestinal bleeding and 15 diverticulitis and/or perforation in the non-obstructive category. The sex discrepancy was higher in the non-obstructive category than in the obstructive category (male-to-female, 4.36 vs. 1.73, p < 0.05). Forty-one of 44 patients with gastrointestinal bleeding underwent a Meckel's scan with a high positive rate (92.7%). The ectopic tissues were identified in 73 patients and included 61 gastric type, two pancreatic type and 10 mixed type. Ectopic tissues were more prevalent in non-obstructive category (p < 0.05) with ectopic gastric tissue even more pronounced (p < 0.01). Ectopic pancreatic tissue was significantly more prevalent in intussusception (p < 0.01). Laparoscopic surgery was performed more frequently in Meckel's diverticulum with non-obstructive symptoms (p < 0.001).
  
  
  CONCLUSIONS
  Diverse presentations in pediatric Meckel's diverticulum are affected by different ectopic tissue types and male sex. Laparoscopic surgery is widely used for children with non-obstructive symptoms.
authors.affiliation: Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Chen-Chuan
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan. Electronic address: a22141@adm.cgmh.org.tw.
authors.forename: Ming-Wei
authors.initials: MW
authors.lastname: Lai
authors.affiliation: Department of Education, National Chiayi University, Chiayi, Taiwan.
authors.forename: Fang-Ming
authors.initials: FM
authors.lastname: Hwang
authors.affiliation: Institute of Education, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Yu-Chen
authors.initials: YC
authors.lastname: Yeh
authors.affiliation: Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Shih-Yen
authors.initials: SY
authors.lastname: Chen
authors.affiliation: Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Man-Shan
authors.initials: MS
authors.lastname: Kong
authors.affiliation: Department of Pediatric Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Jin-Yao
authors.initials: JY
authors.lastname: Lai
authors.affiliation: Department of Pediatric Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Jeng-Chang
authors.initials: JC
authors.lastname: Chen
authors.affiliation: Department of Pediatric Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Yung-Ching
authors.initials: YC
authors.lastname: Ming
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004238:Diverticulitis / Q000209:etiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007443:Intussusception / Q000209:etiology / Q000601:surgery; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008467:Meckel Diverticulum / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D012189:Retrospective Studies
keywords: diverticulitis; ectopic tissue; intussusception