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Background: Rectal bleeding, recurrent abdominal pain, nausea, and vomiting i n children could present a diagnostic as well as therapeutic challenge. Meckel s diverticulum (MD) is one of the causes. The objective of the current study wa s to evaluate the feasibility and outcome of laparoscopic management of MD. Meth ods: The clinical data of 33 children admitted with rectal bleeding and/or recur rent abdominal pain with no identifiable cause were reviewed over a period of 8 years. There were 23 boys and 10 girls with a mean age of 5.12 ± 2 years (rang e, 3- 12 years). In 21 cases, MD was an incidental finding on laparoscopic appe ndectomy and symptomatic in 12 cases. Patients with rectal bleeding were subject ed to upper gastrointestinal endoscopy; colonoscopy, and technetium Tc 99m- lab eled pertechnetate scan (MS). All patients were subjected to routine laboratory investigations and diagnostic laparoscopy. Results: Of the 1200 appendectomies, incidental MD was found in 21 (1.9% ) patients and symptomatic in 12 cases. Upp er gastrointestinal endoscopy and colonoscopy did not show a bleeding source in 7 patients presented with bleeding per rectum. Four cases showed a positive MS u ptake. Of these, 3 were found on laparoscopy to have an MD. Three cases showed a negative scan. Of these, 2 had an MD. In 5 cases with recurrent abdominal pain , nausea, vomiting, and abdominal distention, diagnostic laparoscopy revealed Meckel’s diverticulitis in 3 cases and intussusception secondary to MD in 1 ca se. Laparoscopic Meckel’s diverticulectomy and laparoscopic- assisted Meckel ’s diverticulectomy was done for 18 and 12 cases, respectively. Ectopic gastri c mucosa was present in 13 cases (44% ). Conclusions: Laparoscopy is safe, cost - effective, and efficient for the diagnosis and definitive treatment of MD. Co mpared with conventional laparotomy, it has the advantage of precise operative d iagnosis, less traumatic access, fewer intraoperative and postoperative complica tions, and shorter recovery period.
Background: Rectal bleeding, recurrent abdominal pain, nausea, and vomiting in children could present a diagnostic as well as therapeutic challenge. Meckel s diverticulum (MD) is one of the causes. The objective of the current study wa s to evaluate the feasibility. and outcome of laparoscopic management of MD. Meth ods: The clinical data of 33 children admitted with rectal bleeding and / or recur rent abdominal pain with no identifiable cause were reviewed over a period of 8 years. There were 23 boys and 10 girls with a The mean age of 5.12 ± 2 years (rang e, 3-12 years). In 21 cases, MD was an incidental finding on laparoscopic appe ndectomy and symptomatic in 12 cases. Patients with rectal bleeding were subject ed to upper gastrointestinal endoscopy; colonoscopy, All of the patients were subjected to routine laboratory investigations and diagnostic laparoscopy. Results: Of the 1200 appendectomies, incidental MD was found in 21 (1.9%) and technetium Tc 99m- lab eled pertechnetate scan Patients and symptomatic in 12 cases. Upp er gastrointestinal endoscopy and colonoscopy did not show a bleeding source in 7 patients presented with bleeding per rectum. Four cases showed a positive MS u ptake. Of these, 3 were found on laparoscopy to have an MD. Of these, 2 had an MD. In 5 cases with recurrent abdominal pain, nausea, vomiting, and abdominal distention, diagnostic laparoscopy revealed Meckel’s diverticulitis in 3 cases and intussusception secondary to MD in 1 ca se. Laparoscopic Meckel’s diverticulectomy and laparoscopic-assisted Meckel’s diverticulectomy was done for 18 and 12 cases, respectively. Ectopic gastri c mucosa was present in 13 cases (44%). Conclusions: Laparoscopy is safe, cost-effective, and efficient for the diagnosis and definitive treatment of MD. C mpared with conventional laparotomy, it has the advantage of precise operative d iagnosis, less traumatic access, fewer intraoperative and postoperative complications ions, and shorter recovery period.