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A Clinical Manifestation of Meckel's Diverticulum

Journal of the Korean Pediatric Society 2002;45(4):466-472.
Published online April 15, 2002.
A Clinical Manifestation of Meckel's Diverticulum
Jin Beom Lee1, Yong Soon Lee2, Eun Sun Yoo1, Hae Soon Kim1, Se Jeong Son1, Eun Ae Park1, Seung Joo Lee1, Sun Hee Sung3, Jeong Wan Seo1
1Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
2Department of Pediatrics, Dongbu Municipal Hospital, Seoul, Korea
3Department of Pathology, College of Medicine, Ewha Womans University, Seoul, Korea
Meckel 게실의 임상양상
이진범1, 이용순2, 유은선1, 김혜순1, 손세정1, 박은애1, 이승주1, 성순희3, 서정완1
1이화여자대학교 의과대학 소아과학교실
2이화여자대학교 시립동부병원 소아과
3이화여자대학교 의과대학 병리학교실
Jeong Wan Seo, Email: jwseo@mm.ewha.ac.kr
: The diagnosis of Meckel's diverticulum is difficult and delayed because it presents with various clinical symptoms. We evaluated clinical, imaging and pathologic findings of Meckel's diverticulum to facilitate detection of Meckel's diverticulum in children.
: Review of clinical, imaging, surgical and pathological findings in 10 children aged 7 days to 14 years with Meckel's diverticulum during an 8-year period, 1993-2001, at Ewha Womans University Hospital was undertaken.
: The male to female ratio was 2.3 : 1. The chief complaint was painless lower gastrointestinal(GI) bleeding; others were abdominal pain, abdominal distention and vomiting, in order of frequency. The diagonsis before surgery were Meckel's diverticulum in 5 patients, non-reducible intussusception in 3 patients and intestinal obstruction in 2 patients. The diverticulum was located between 35 cm to 70 cm proximal to the ileocecal valve. The length of the diverticulum ranged from 4 cm to 12 cm and 80% of it was within 5 cm. A Meckel scan(99mTc-pertechnetate scintigraphy) after cimetidine administration was done in 6 cases. All 5 cases that presented with lower GI bleeding had ectopic gastric mucosa confirmed on pathology. Out of 5 cases of ectopic gastric mucosa, only 4 cases were positive on the Meckel's scan.
: In cases of unexplained GI bleeding, obstruction, or inflammation diagnostic workup should be carried out to rule out Meckel's diverticulum. Laparoscopy, high resolution ultrasonography and computed tomography of the abdomen may be indicated in the assessment of pediatric patient with lower GI bleeding, especially in patients with suspected bleeding from Meckel's diverticulum showing negative Meckel's scan.
Key Words: Meckel's diverticulum, Meckel's scan, Children

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