Clinical Features, Diagnostic Methods, and Treatment Approaches for Meckel’s Diverticulum in Children and Adolescents: Experience of One Center
Abstract
Background: Meckel's diverticulum is one of the most common congenital anomalies of the gastrointestinal tract, which is often detected in children.This study aims to conduct a comparative analysis of the clinical manifestations of Meckel's diverticulum complications across different pediatric age groups, based on surgical interventions performed at the Emergency Medical Care Center.Methods and Results: During the period from 2017 to 2024, at the Republican Scientific Center of Emergency Medical Care (RSCEMC), in the Department of Pediatric Emergency Surgery, surgical treatment was provided to 132 children and adolescents aged from 4 months to 18 years with various forms of complicated and uncomplicated Meckel's diverticulum.Taking into account the generally accepted pediatric age classification, the material was divided into three age groups: the infancy-to-toddler group (Group 1), from 4 months to 3 years -39 (29.5%) children, mean age of 1.470.91years; the early-to-middle childhood group (Group 2), 4-11 years -64 (48.5%) patients, mean age of 8.62.29 years; the adolescence group (Group 3), 12-18 years -29 (22%) children, mean age of 14.931.72years.The study involved a retrospective analysis of patients' medical records, including clinical, instrumental, and laparoscopic methods.The clinical manifestation of Meckel's diverticulum varies.In some cases, it mimics acute appendicitis, in others, acute intestinal obstruction, which depends on the patient's age and the time of admission from the onset of the disease.In children aged 0-3 years with gastrointestinal bleeding, Meckel's diverticulum is most often suspected.In children aged 0-3 years, when Meckel's diverticulum is suspected, it is advisable to begin the intervention with laparotomy, which is associated with a high proportion of complicated forms (diverticulitis, necrosis, intussusception).In older children, the choice of surgical access is determined by the clinical picture and the preliminary diagnosis.In children aged 4-11 years, it is more often possible to perform less traumatic interventions; complicated forms are less common; however, the diverticulum is frequently removed simultaneously with the appendix due to a similar clinical presentation.In adolescents aged 12-18 years, laparoscopic and combined interventions predominate, characterized by lower invasiveness; complicated forms are recorded much less frequently.(