Clinical Features, Diagnostic Methods, and Treatment Approaches for Meckel’s Diverticulum in Children and Adolescents: Experience of One Center

International Journal of Biomedicine 15(4) (2025) 679-684 http://dx.doi.org/10.21103/Article15(4)_OA5 ORIGINAL ARTICLE INTERNATIONAL JOURNAL OF BIOMEDICINE Surgery Clinical Features, Diagnostic Methods, and Treatment Approaches for Meckel’s Diverticulum in Children and Adolescents: Experience of One Center J. А. Djurayev 1,3, A. A. Ismatov4, R. N. Ismailova3, Sh. Z. Nizamxodjayev3, M. A. G’aniyev1, P. K. Sultanov 2,4* Republican Scientific Center of Emergency Medical Care, Tashkent, Uzbekistan Tashkent State Medical University, Tashkent, Uzbekistan 3 Kimyo International University in Tashkent, Tashkent, Uzbekistan 4 Republic Specialized Scientific-Practical Medical Center of Nephrology and Kidney Transplantation, Tashkent, Uzbekistan 1 2 Abstract Background: Meckel’s diverticulum is one of the most common congenital anomalies of the gastrointestinal tract, which is often detected in children. This study aims to conduct a comparative analysis of the clinical manifestations of Meckel’s diverticulum complications across different pediatric age groups, based on surgical interventions performed at the Emergency Medical Care Center. Methods and Results: During the period from 2017 to 2024, at the Republican Scientific Center of Emergency Medical Care (RSCEMC), in the Department of Pediatric Emergency Surgery, surgical treatment was provided to 132 children and adolescents aged from 4 months to 18 years with various forms of complicated and uncomplicated Meckel’s diverticulum. Taking into account the generally accepted pediatric age classification, the material was divided into three age groups: the infancy-to-toddler group (Group 1), from 4 months to 3 years – 39 (29.5%) children, mean age of 1.47±0.91 years; the early-to-middle childhood group (Group 2), 4–11 years – 64 (48.5%) patients, mean age of 8.6±2.29 years; the adolescence group (Group 3), 12–18 years – 29 (22%) children, mean age of 14.93±1.72 years. The study involved a retrospective analysis of patients’ medical records, including clinical, instrumental, and laparoscopic methods. The clinical manifestation of Meckel’s diverticulum varies. In some cases, it mimics acute appendicitis, in others, acute intestinal obstruction, which depends on the patient’s age and the time of admission from the onset of the disease. In children aged 0–3 years with gastrointestinal bleeding, Meckel’s diverticulum is most often suspected. In children aged 0–3 years, when Meckel’s diverticulum is suspected, it is advisable to begin the intervention with laparotomy, which is associated with a high proportion of complicated forms (diverticulitis, necrosis, intussusception). In older children, the choice of surgical access is determined by the clinical picture and the preliminary diagnosis. In children aged 4-11 years, it is more often possible to perform less traumatic interventions; complicated forms are less common; however, the diverticulum is frequently removed simultaneously with the appendix due to a similar clinical presentation. In adolescents aged 12-18 years, laparoscopic and combined interventions predominate, characterized by lower invasiveness; complicated forms are recorded much less frequently. (International Journal of Biomedicine. 2025;15(4):679-684.) Keywords: Meckel’s diverticulum • pediatric surgery • acute abdomen • complications For citation: Djurayev JA, Ismatov AA, Ismailova RN, Nizamxodjayev ShZ, G’aniyev MA, Sultanov PK. Clinical Features, Diagnostic Methods, and Treatment Approaches for Meckel’s Diverticulum in Children and Adolescents: Experience of One Center. International Journal of Biomedicine. 2025;15(4):679-684. doi:10.21103/Article15(4)_OA5 Introduction Meckel’s diverticulum is a congenital anomaly of the vitelline duct of the ileum.1,2 First described in 1809 by the German anatomist J. Meckel, it resembles the vermiform appendix in shape. The prevalence of this pathology is about 2–3% in the general population, and it is most frequently identified in children and adolescents.3 The diverticulum can 680 J. А. Djurayev et al. / Journal of Biomedicine 15(4) (2025) 679-684 present in various forms, but most commonly appears as a protrusion of the ileal wall on the antimesenteric border, with a free communication to the intestinal lumen.1 The clinical presentation of Meckel’s diverticulum can vary widely, ranging from an asymptomatic course to serious complications such as gastrointestinal bleeding, intussusception, Meckelitis (intestinal inflammation), intestinal obstruction, or perforation.3-5 Therefore, timely diagnosis and appropriate management are crucial in preventing complications of Meckel’s diverticulum. This study aims to conduct a comparative analysis of the clinical manifestations of Meckel’s diverticulum complications across different pediatric age groups, based on surgical interventions performed at the Emergency Medical Care Center. Materials and Methods During the period from 2017 to 2024, at the Republican Scientific Center of Emergency Medical Care (RSCEMC), in the Department of Pediatric Emergency Surgery, surgical treatment was provided to 132 children and adolescents aged from 4 months to 18 years with various forms of complicated and uncomplicated Meckel’s diverticulum. Taking into account the generally accepted pediatric age classification, the material was divided into three age groups: the infancy-to-toddler group (Group 1), from 4 months to 3 years – 39 (29.5%) children, mean age of 1.47±0.91 years; the early-to-middle childhood group (Group 2), 4–11 years – 64 (48.5%) patients, mean age of 8.6±2.29 years; the adolescence group (Group 3), 12–18 years – 29 (22%) children, mean age of 14.93±1.72 years. Among them, boys accounted for 99 (75%), which confirms the higher incidence of this pathology in males, whereas girls accounted for 33 (25%). The study involved a retrospective analysis of patients’ medical records, including clinical, instrumental, and laparoscopic methods, and statistical analysis using IBM SPSS Statistics 23, with descriptive statistics applied. Baseline characteristics were summarized as frequencies and percentages for categorical variables. Group comparisons concerning categorical variables were performed using chi-square or Fisher’s exact tests. A P-value of < 0.05 was considered statistically significant. From the analyzed surgical intervention data at the RSCEMC, surgeries performed due to complications of Meckel’s diverticulum accounted for 0.82% (Fig. 2). Fig. 2. Dynamics of surgeries for complications of Meckel’s diverticulum in children by year. In our series, the clinical presentation of Meckel’s diverticulum was nonspecific, and most often patients were admitted under the guise of other acute surgical diseases of the abdominal cavity, including symptoms of complications of an undiagnosed underlying condition (Table 1). Table 1. Preoperative diagnosis in patients with Meckel’s diverticulum. Preoperative diagnosis Group 2 n=64 Meckel’s di (...truncated)