Clinico-Pathology Study of Vitellointestinal Remnants in Children
Abstract
Background & Aim: Persistence of vitellointestinal duct can manifest in different ways. Aim was to analyse the age and sex incidence, symptomatology, preoperative diagnosis, operative findings, postoperative complications, histological findings and associated congenital malformations of vitellointestinal remnants in children.
Methods: Retrospective study of hospital records for 30 years in a tertiary care centre.The data based on proforma was collected and analyzed. The findings were compared with similar published data.
Results: 165 cases were analysed. Meckel’s diverticulum was most frequently found in 0-2 year age group, with a male : female ration of 2.8 :1. The ratio of symptomatic to asymptomatic cases was 4:1. Intestinal obstruction was the most common preoperative diagnosis and accounted for the majority of cases at operation. Vitelleintestinal band causing external compression was the commonest cause of obstruction. Volvulus of the intestine due to such band was the second and intussusception was the third cause of obstruction, in which Meckel’s diverticulum was the lead point in 36%. Meckel’s diverticulitis was the next common operative diagnosis (25%). Bleeding per rectum was the manifestation in 13% cases. On histopathologic examination of Meckel’s diverticulum, ectopic gastric tissue was found in 10% cases. A number of congenital anomalies were identified to co-exist with Meckel’s diverticulum. The mortality rate was 6.6%.
Conclusion: Meckel’s diverticulum is the commonest anomaly of persistent vitellointestinal duct. Intestinal obstruction, diverticulitis, and bleeding per rectum are the commonest presentations in contrast to intestinal obstruction, bleeding per rectum followed by diverticulitis as found in some other studies.
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