Clinical Features of Symptomatic Meckel’s Diverticulum in Children: Comparison of Scintigraphic and Non-scintigraphic Diagnosis
노정희, Tchah Hann, 전인상, 손동우, 류일, 조강호, 최덕영, 김재숙, 김순기, 김상룡, 최윤미, 김성민, 김윤미,
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노정희 ( Rho Jung-Hee )
Gachon University Gil Medical Center Department of Pediatrics
( Tchah Hann )
Gachon University Gil Medical Center Department of Pediatrics
전인상 ( Jeon In-Sang )
Gachon University Gil Medical Center Department of Pediatrics
손동우 ( Son Dong-Woo )
Gachon University Gil Medical Center Department of Pediatrics
류일 ( Ryoo Eell )
Gachon University Gil Medical Center Department of Pediatrics
조강호 ( Cho Kang-Ho )
Gachon University Gil Medical Center Department of Pediatrics
최덕영 ( Choi Deok-Young )
Gachon University Gil Medical Center Department of Pediatrics
김재숙 ( Kim Jae-Sook )
Inha University Hospital Department of Pediatrics
김순기 ( Kim Soon-Ki )
Inha University Hospital Department of Pediatrics
김상룡 ( Kim Sang-Yong )
Catholic University Incheon St. Mary’s Hospital Department of Pediatrics
최윤미 ( Choi Yoon-Mi )
Inha University Hospital Department of Pediatric Surgery
김성민 ( Kim Sung-Min )
Gachon University Gil Medical Center Department of Pediatric Surgery
김윤미 ( Kim Yoon-Mi )
Gachon University College of Nursing Department of Nursing Science
KMID : 0816120130160010041
Abstract
Purpose: Meckel’s diverticulum (MD) has various clinical manifestations, and diagnosis or selectection of proper diagnostic tools is not easy. This study was conducted in order to assess the clinical differences of MD diagnosed by scintigraphic and non-scintigraphic methods and to find the proper diagnostic tools.
Methods: We conducted a retrospective review ofthe clinical, surgical, radiologic, and pathologic findings of 34 children with symptomatic MD, who were admitted to Gachon University Gil Medical Center, Inha University Hospital, and The Catholic University of Korea, Incheon St. Mary’s Hospital between January 2000 and December 2012. The patients were evaluated according to scintigraphic (12 cases; group 1) and non-scintigraphic (22 cases; group 2) diagnosis.
Results: The male to female ratio was 7.5: 1. The most frequent chief complaint was lower gastrointestinal (GI) bleeding in group 1 and nonspecific abdominal pain in group 2, respectively. The most frequent pre-operative diagnosis was MD in both groups. Red blood cell (RBC) index was significantly lower in group 1. MD was located at 7 cm to 85 cm from the ileocecal valve. Four patients in group 1 had ectopic gastric tissues causing lower GI bleeding. The most frequent treatment modality was diverticulectomy in group 1 and ileal resection in group 2, respectively.
Conclusion: To diagnose MD might be delayed unless proper diagnostic tools are considered. It is important to understand indications of scintigraphic and non-scintigraphic methods according to clinical and hematologic features of MD. Scintigraphy would be weighed in patients with anemia as well as GI symptoms.
키워드
Meckel’s diverticulum;Scintigraphy;Meckel’s scan;Diagnosis;Child;Radionuclide imaging
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