[Pathologic assessment of Meckel's diverticulum specimens; a ten year study]

ABSTRACT

Meckel's diverticulum is one of the most common congenital anomalies of gastrointestinal tract. Our aim was to study pathologic features of surgical specimens of the diverticulum and to assess the type of lining mucosa, presence of Helicobacter pylori and inflammatory changes. We studied patients' medical records and pathology files of the years 1994 through 2004, of the patients who underwent surgery with the diagnosis of Meckel's diverticulum in Children's Medical Center, Tehran. Pathologic features such as length and lining of the diverticulum and other variables such as age, gender and clinical signs were studied. We found 45 specimens in this period [80% male 20% female]. The mean age was 3.8 years [25 days to 11 years] and most of the patients were between 2 to 4 years old [33.6%]. Most common clinical symptoms were abdominal pain [17] and hematochesis [4]; 20 patients had combined symptoms such as abdominal pain and melena. Only 9 patients with lower gastrointestinal bleeding had Technetium scan and all of them were positive. Associated findings during surgery included appendicitis and invagination. Twenty diverticulae were inflamed in pathologic report, 8 with gangrene and 5 with perforation. Pathologic examination of specimens revealed a mean diameter of 2 cm [range 0.4-4.5] and a mean length of 3.8 cm [range 1-10]. Lining was of intestinal type in 27 [60%], gastric in 10 [22.2%] and combined in 8 specimens [17.8%]. 11 specimens from 18 that were lined by gastric type of mucosa showed no Helicobacter pylori in Giemsa stain [2 had mucosal necrosis]. Clinical findings of Meckel's diverticulum in our study were rather the same as in literature. The most efficient way of diagnosis was Technetium scan. Pathologic examination of specimens revealed that most diverticulae were lined by intestinal type of mucosa. None of those with gastric type of mucosa showed Helicobacter Pylori infection