title: Meckel diverticulum in children: Evaluation of macroscopic appearance for guidance in subsequent surgery.
abstract: BACKGROUND
  The treatment of incidentally encountered asymptomatic Meckel diverticulum (MD) is controversial. We evaluated whether the macroscopic appearance correlates with clinical features, histopathological findings, future complications, and management decisions.
  
  
  METHODS
  Patients who underwent MD resection at a single institution from 2000 to 2012 were retrospectively analyzed in terms of age, sex, clinical features, laboratory data, perioperative findings (diverticulum length, diameter, depth, thickening, and height-to diameter ratio [HDR]), pathology, and postoperative follow-up.
  
  
  RESULTS
  Fifty children were enrolled. Sixteen percent of the resected MDs were found incidentally. Of 42 complicated MDs, 17 (40%) were long (HDR ≥2), 14 (33%) were thickened, and 29 (70%) exhibited base widening. Histopathologically, ectopic mucosa was found in 32 (64%) of all MDs and in 5 (62%) of incidentally removed MDs. There was no statistical difference between the macroscopic appearance and clinical signs, sex, or presence of ectopic tissue based on palpation.
  
  
  CONCLUSIONS
  The macroscopic appearance of MD does not indicate the presence or absence of HGM and cannot be used to guide subsequent surgery. Additionally, 40% of symptomatic patients in our study had life-threatening complications requiring prompt fluid resuscitation. We consider that incidentally detected MD should be removed regardless of its macroscopic appearance.
authors.affiliation: Department of Pediatric Surgery, Başkent University Faculty of Medicine, Ankara, Turkey. Electronic address: hozkangezer@yahoo.com.tr.
authors.forename: Hasan Özkan
authors.initials: HÖ
authors.lastname: Gezer
authors.affiliation: Department of Pediatric Surgery, Başkent University Faculty of Medicine, Ankara, Turkey. Electronic address: aktemiz@yahoo.com.
authors.forename: Abdulkerim
authors.initials: A
authors.lastname: Temiz
authors.affiliation: Department of Pediatric Surgery, Başkent University Faculty of Medicine, Ankara, Turkey. Electronic address: inceemine@mynet.com.
authors.forename: Emine
authors.initials: E
authors.lastname: İnce
authors.affiliation: Department of Pediatric Surgery, Başkent University Faculty of Medicine, Ankara, Turkey. Electronic address: semireserin@yahoo.com.
authors.forename: Semire Serin
authors.initials: SS
authors.lastname: Ezer
authors.affiliation: Department of Pathology, Başkent University Faculty of Medicine, Ankara, Turkey. Electronic address: bermalhasbay@hotmail.com.
authors.forename: Bermal
authors.initials: B
authors.lastname: Hasbay
authors.affiliation: Department of Pediatric Surgery, Başkent University Faculty of Medicine, Ankara, Turkey. Electronic address: akgunhicsonmez@gmail.com.
authors.forename: Akgun
authors.initials: A
authors.lastname: Hiçsönmez
mesh_terms: D000293:Adolescent; D058070:Asymptomatic Diseases; D002648:Child; D002675:Child, Preschool; D000066491:Clinical Decision-Making; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033162:Incidental Findings; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008467:Meckel Diverticulum / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Children; Incidentally; Macroscopic appearance; Meckel diverticulum; Prophylactic