• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.222-225
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• 2005

Meckel's diverticulum is generally acknowledged to be the most prevalent congenital anomaly of the gastrointestinal tract. The preoperative diagnosis of Meckel's diverticulum is difficult, especially in neonates, because of the lesions ability to masquerade as one of a variety of much more common abdominal pathologies. Recently we experienced a case of perforated Meckel's diverticulum with mild inflammatory reaction, intestinal adhesion, and small bowel obstruction in a previous healthy 9-day-old neonate. The spontaneous perforation of Meckel's diverticulum in neonate is very rare but serious entity. The course was rapid and progressed to sepsis. So despite its varied presentation, Meckel's diverticulum should be kept in mind as a cause of acute abdomen in neonates.

• Clinical and Experimental Pediatrics
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• v.45 no.4
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• pp.466-472
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• 2002

Purpose : 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. Methods : 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. Results : 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($^{99m}Tc-pertechnetate$ 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. Conclusion : 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.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.1
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• pp.98-104
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• 2019

We report a rare case of Meckel's diverticulum in a boy who initially presented with chronic iron deficiency anemia (IDA) without any history of gastrointestinal (GI) bleeding at 8 years-old. Isolated small bowel Crohn's disease was suspected based on findings of small bowel ulcers on capsule endoscopy. At four years from initial presentation, he developed massive GI bleeding. Abdominal computed tomographic angiography and small bowel series revealed findings suggestive of Meckel's diverticulum. Meckel's diverticulum should be suspected in children with unexplained chronic IDA even in the absence of prominent GI bleeding and negative findings on repetitive Meckel's scans. Moreover, Meckel's diverticulum should be included in the differential diagnosis of isolated small bowel Crohn's disease when the disease is limited to a short segment of the distal small bowel, as ulcers and inflammation may result as a consequence of acid secreted from adjacent heterotopic gastric mucosa constituting the Meckel's diverticulum.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.1
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• pp.119-123
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• 2004

Meckel's diverticulum is the most common malformation of gastrointestinal tract. Symptoms of Meckel's diverticulum usually arise within 2 years of life. The most common presentations include hemorrhage, perforation, diverticulitis and intestinal obstruction. Perforation of the Meckel's diverticulum in a neonate is uncommon but life threatening condition. We describe the first case of perforation of Meckel's diverticulum in a 1-day-old neonate who presented with abdominal distension without hemorrhage.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.9 no.1
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• pp.75-79
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• 2006

Intussusception is a frequent cause of intestinal obstruction in early childhood and most are idiopathic in origin. In a minority of cases a definite pathological lead point is identified by imaging studying or during surgery. As the pathologic lead point of intussusception, Meckel's diverticulum is the most common lesion. In symptomatic patients, 40~60% of Meckel's diverticulum contain ectopic tissue, with gastric mucosa being far the most common type. A few Meckel's diverticulum contain pancreatic tissue. Combined heterotopic pancreatic and gastric tissues in the Meckel's diverticulum especially causing intussusception is extremely rare. We report the case of 5-year-old girl with an intussusception caused by Meckel's diverticulum containing both heterotopic gastric and pancreatic tissues.

• Advances in pediatric surgery
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• v.7 no.2
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• pp.157-161
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• 2001

Meckel's diverticulum is one of the common causes of gastrointestinal bleeding in the pediatric patient requiring laparotomy. Two children with Meckel's diverticulum have been successfully treated by laparoscopic excision. Both patients recovered without incident and were discharged at 3 and 5 days after surgery. The authors believe that laparoscopic diverticulectomy is a safe, effective. and minimal invasive treatment of Meckel's diverticulum in children.

• The korean journal of orthodontics
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• v.26 no.2 s.55
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• pp.187-196
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• 1996

Underlying malocclusions and dentofacial deformities are often related to variations in the craniofacial development. Type I and type II collagens are considered the major collagens of bone and cartilage respectively. Monitoring the patterns of those protein expressions during development will Provide a basis for the understanding of normal and abnormal growths. This study was undertaken to investigate the morphogenetic changes and the expression patterns of type I and II collagen proteins involved in the developing mandible of human embryos and fetuses. 50 embryos and fetuses were studied with Hematoxylin and Eosin, Alcian, blue-PAS, Masson Trichrome, md Immunohistochemical stains. The results were as follows : 1. A 13.5 mm embryo showed the stomatodeum with dental lamina, maxillary and mandibular processes. Meckel's cartilage appeared in the mandibular arch of a 20.5 mm embryo. New bone formation was bilaterally initiated at the outer side of middle portion of Meckel's cartilage of 22-38 mm embryos. 2. Meckel'cartilage was resorbed at the 15th week fetus. The endochondral ossification was observed where there was direct replacement of cartilage by bone. Meckel'cartilage disappeared and membraneous ossification were observed at the 25th week. 3. Before the appearance of Meckel's cartilage, the expression of type I collagen was moderate at the odontogenic epithelium of maxillary & mandibular process, but mild for the expression of type II collagen. 4. During the appearance of Meckel's cartilage and new bone formation, the immunoactivity of type II collagen was more expressed than type I collagen at the Meckel's cartilage and new bone. 5. During intrarmembranous bone formation, the expression of type II collagen was rare in the bony trabeculae. There was a switch for the expression of collagens from type II to type I during the appearance of Meckel's cartilage.

• Advances in pediatric surgery
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• v.13 no.2
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• pp.127-134
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• 2007

Meckel's diverticulum is the most common congenital anomaly of gastrointestinal tract in children. The incidence of complicated Meckel's diverticulum is about 4 %. The major complications of Meckel's diverticulum are bleeding, intussusception, obstruction and perforation. The aim of this study was to investigate the clinical manifestations and the role of laparoscopic surgery in complicated Meckel's diverticulum in children. We retrospectively reviewed the medical records of 19 patients with complicated Meckel's diverticulum who underwent operation at Asan Medical Center between Jan. 1990 and Apr. 2007. Male to female ratio was 11:8, and median age was 1 year (1 day-13 years). The most frequent symptom was hematochezia (68%), followed by irritability or abdominal pain (16%), vomiting (11%), and abdominal distension (5%). Two operative procedures were performed; small bowel resection with anastomosis (68%) and diverticulectomy (32%). The operation proven complications of the Meckel's diverticulum were bleeding (68%), intussusception (16%), perforation (11%) and obstruction (5%). Ectopic tissues found by postoperative pathologic examination were gastric (84%) and pancreatic (11%). Hospital stay after laparoscopic operation for bleeding Meckel's was 5 days (median) and average first postoperative feeding was 1.5 days. On the contrary, hospital stay for open surgery was 7 days and first feed was 3 days. In summary, the most common compliation of Meckel's diverticulum in children was bleeding and ectopic gastric tissues were present in 84%. Laparoscopic procedure seemed to be useful for diagnosis as well as for definitive treatment.

• Journal of Yeungnam Medical Science
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• v.4 no.1
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• pp.129-132
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• 1987

Two cases of bleeding Meckel's diverticulum diagnosed by $^{99m}$Technetium-pertechnetate scanning are presented. $^{99m}TC$-pertechnetate was used in the diagnosis of Meckel's diverticulum by Jewette et al. in 1970 for the first time. The affinity of this isotope for the parietal cell of the gastric mucosa makes it ideal for delineating ectopic gastric tissue. Its noninvasiveness can be used in early screening test for occult gastrointestinal bleeding in pediatric age group.

• Advances in pediatric surgery
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• v.14 no.2
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• pp.200-204
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• 2008

The term "Littre's hernia" was originally defined by Reinke in 1841 as "the presence of a Meckel's diverticulum in any hernia sac." Littre's hernia is a very rare disease, which accounts for less than 1 % of all Meckel's diverticula. We report a case of Littre's hernia experienced in a 45 day-old infant.