ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Surgery
Volume 13 - 2025 | doi: 10.3389/fped.2025.1617214
This article is part of the Research TopicAdvances in Etiology Research and Clinical Intervention Strategies for Congenital Intestinal Malformations in ChildrenView all 4 articles
Comparison of clinical manifestations and immunoreactivities of Meckel's Diverticulum with and without gastric heteroplasia
Provisionally accepted
- 1Children's Hospital of Soochow University, Suzhou, China
- 2Suzhou Wujiang District Children’s Hospital, suzhou, China
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Objective: This study aimed to characterize the clinicopathological features of pediatric Meckel's diverticulum (MD) and evaluate the diagnostic performance of imaging modalities, with particular emphasis on the role of heterotopic mucosa. Methods: We performed a retrospective analysis of 111 surgically confirmed pediatric Meckel's diverticulum (MD) cases from 2017 to 2023 at a tertiary pediatric center. Patients were stratified into heterotopic and non-heterotopic groups based on histopathological findings. Demographic, clinical, imaging, and immunohistochemical data were analyzed using SPSS version 26.0. Results: The cohort exhibited male predominance (ratio 4.29:1) and a young age of onset, with 28.8% of patients being ≤3 years old. Heterotopic mucosa, predominantly gastric (74.8%), showed a strong correlation with gastrointestinal bleeding (p<0.0001), whereas non-heterotopic patients more frequently presented with obstruction. Technetium-99m pertechnetate scintigraphy demonstrated significantly higher sensitivity compared to ultrasound (p<0.001). Immunohistochemistry revealed SOX2/MUC5AC expression in heterotopic tissue, contrasting with CDX2 dominance in nonheterotopic patients. All patients underwent successful resection, with no significant differences in outcomes based on the surgical approach employed. Conclusions: Heterotopic mucosa defines distinct Meckel's diverticulum (MD) subtypes, each with characteristic clinical presentations. Technetium-99m pertechnetate scintigraphy, despite its specificity limitations, is optimal for evaluating patients with bleeding, whereas ultrasound demonstrates poor sensitivity. These findings support the adoption of tailored diagnostic strategies and advocate for universal resection in children with symptomatic MD.
Keywords: Meckel's diverticulum, gastric heteroplasia, Child, clinical manifestations, Immunoreactivities
Received: 24 Apr 2025; Accepted: 26 Jun 2025.
Copyright: © 2025 Zhang, Zhou, Cai, Rui Yun and Zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhenwei Zhu, Children's Hospital of Soochow University, Suzhou, China
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