Journal of pediatric gastroenterology and nutrition · 2026
Reevaluating the rule of two's: Age and epidemiological variations in Meckel's diverticulum.
СтатьяНазвание и аннотация: Перевод в очереди
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Polachek Ashley, Mehta Megha S, Shalaby Ahmed, Vadsariya Aamirah, Zong Wenjing, Troendle David M
Аннотация
OBJECTIVE: To evaluate the clinical characteristics, diagnostic modalities, and age-related variation of Meckel's diverticulum (MD) using data from a nationwide pediatric inpatient database and a single-center institutional cohort.
METHODS: The Kids' Inpatient Database (KID) for 2016 and 2019 was queried for patients with a principal diagnosis of MD. We additionally conducted a retrospective review of patients hospitalized with a primary diagnosis of MD at our institution over a 20-year period (January 1, 2005-May 1, 2025). Diagnosis was confirmed by surgical findings and pathology.
RESULTS: A total of 1004 patients with a primary diagnosis of MD were identified in KID. More than half were diagnosed after 5 years of age (n = 648, 64.8%). Similarly, among 147 patients identified in the single-center cohort, 63.2% (n = 93) were diagnosed after 5 years of age. Within this single-center cohort, patients ≤5 years more commonly presented with painless rectal bleeding (38.9%, p = 0.017) and underwent Meckel's scintigraphy more frequently (48.1%, p < 0.005). In contrast, patients >5 years more often presented with abdominal pain (61.3%) or vomiting (54.8%) and were more likely to undergo abdominal computed tomography (68.9%, p < 0.0001). Length of stay (LOS) was longer in patients <5 years and shortest in those >15 years (p = 0.04).
CONCLUSION: More than half of pediatric patients with MD are diagnosed after 5 years of age. Presentation, LOS, and imaging patterns vary by age, with younger children more often presenting with bleeding and older children with obstructive symptoms and greater CT detection.
METHODS: The Kids' Inpatient Database (KID) for 2016 and 2019 was queried for patients with a principal diagnosis of MD. We additionally conducted a retrospective review of patients hospitalized with a primary diagnosis of MD at our institution over a 20-year period (January 1, 2005-May 1, 2025). Diagnosis was confirmed by surgical findings and pathology.
RESULTS: A total of 1004 patients with a primary diagnosis of MD were identified in KID. More than half were diagnosed after 5 years of age (n = 648, 64.8%). Similarly, among 147 patients identified in the single-center cohort, 63.2% (n = 93) were diagnosed after 5 years of age. Within this single-center cohort, patients ≤5 years more commonly presented with painless rectal bleeding (38.9%, p = 0.017) and underwent Meckel's scintigraphy more frequently (48.1%, p < 0.005). In contrast, patients >5 years more often presented with abdominal pain (61.3%) or vomiting (54.8%) and were more likely to undergo abdominal computed tomography (68.9%, p < 0.0001). Length of stay (LOS) was longer in patients <5 years and shortest in those >15 years (p = 0.04).
CONCLUSION: More than half of pediatric patients with MD are diagnosed after 5 years of age. Presentation, LOS, and imaging patterns vary by age, with younger children more often presenting with bleeding and older children with obstructive symptoms and greater CT detection.