Divertículo de Meckel: aspectos clínicos e cirúrgicos em um hospital pediátrico de referência

Abstract

OBJECTIVE: To evaluate the epidemiological profile of symptomatic Meckels diverticulum in patients admitted to a specialized childrens hospital from January 2009 to December 2018. METHODS: This retrospective study analyzed the medical records of patients admitted to a childrens hospital in Curitiba (Paraná-Brazil) from 01/01/2009 to 31/12/2018. RESULTS: We found an incidence of 5.3 cases of symptomatic Meckels diverticulum per year. Of the 43 medical records, there was a predominance of male patients (69.7%) and 21 (48.8%) were less than 1-year-old. As for the clinical presentation,15 patients presented acute abdominal inflammation (34.8%), 9 acute abdominal hemorrhage (21%), and 6 acute abdominal obstruction (14%). 13 patients (30.2%) presented unspecific condition and were not classified. Regarding treatment, 41 patients (95.2%) underwent segmental enterectomy with enteroanastomosis. Ectopic mucosa was found in 19 anatomopathological examinations, 16 of which were gastric in origin, 1 pancreatic, and 2 had both mucosae. Post-operative complications included wound dehiscence (4.6%), paralytic ileus (4.6%), and peritonitis (2.3%). Of the 41 patients, 38 were discharged (88.4%), and 5 (11.6%) died. CONCLUSION: Meckels diverticulum had a propensity to manifest in children who were breastfeeding, most often with inflammation and hemorrhage. Of the 9 patients who manifested hemorrhage, 7 (78%) showed ectopic mucosa, which indicates a likely relationship between the presence of ectopic mucosa and hemorrhage. The percentage of patients who died is higher in our sample than in the literature; those who died were predominantly male and 4 (80%) were younger than 1