Recurred Ameloblastoma: A Case Report

Perforation of Meckel's Diverticulum in Children

Meckel's diverticulum (MD) occurs in approximately 2 % of the population. The major complications of MD are bleeding, intestinal obstruction, infection and perforation. Perforation is the least common but most serious complication, the incidence od which is about 5-10 %. The causes of perforation are inflammatory diverticulitis and peptic ulceration. the purpose of study is to review the characteristics of perforated MD in children. Six patients with perforated MD who had been operated upon at the Department of Pediatric Surgery, Yeungnam University Hospital from April 1984 to July 2001 were included. Male predominated in a ratio of 5:1 and there were 2 neonates. The chief complaints were abdominal pain and distension. Half of the children showed a past history of bloody stools. The average age was 4 year and 9 months. The mean distance from the ileocecal valve to the diverticulum was 60 cm. Average length of the diverticulum was approximately 3 cm and width was 1.7 cm. The perforation site was the tip of the diverticulum in 3 cases, the base in 2 cases and along the lateral border in one. In two patients, ectopic gastric mucosa was found in the specimen. All of the patients were operated upon with a diagnosis of peritonitis of unknown etiology. In conclusion, when a child shows symptoms of acute abdomen or peritonitis, especially in boys, with the history of bloody stools and episodic abdominal pain, perforated MD should be suspected.

Diagnosis and Treatment of Bleeding Meckel's Diverticulum

The major complications of Meckel's diverticulum(MD) are bleeding, intestinal obstruction, infection, umbilical fistula and perforation. Although the relative incidences vary between authors, bleeding is the most common complication in children. The aim of our study is to show the symptomatic guideline for the diagnosis of the bleeding MD. Eight cases with bleeding MD which were operated upon at the department of Pediatric Surgery, Yeungnam University Hospital from April 1985 to April 2001 were reviewed. Half of the patients were under 2 years of age and all patients were male. All patients were preoperatively diagnosed by previous history of intestinal bleeding (melena, hematochezia) and 99mTc pertechnetate MD scan. Segmental resection and end-to-end anastomosis was performed in 6 patients and diverticulectomy in 2 patients. Heterotropic gastric mucosa was found in 6 patients. Postoperative complication was not observed in any cases. In conclusion, in any male children with obscure intestinal bleeding, especially less than 2 years of age, bleeding MD must be suspected. It seems to us that 99mTc pertechnetate MD scan is a useful tool to diagnose bleeding MD.