Meckel's diverticulum epidemiology and demographics: Difference between revisions
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==Overview== | ==Overview== | ||
Meckel's diverticulum is present in approximately 2% of the population, with | Meckel's diverticulum is present in approximately 2% of the population, as per the "Rule of 2s". This rule applies to patients with Meckel's diverticulum and states that it affects approximately 2 percent of the population with a male-to-female ratio of 2:1. It is mostly located about two feet proximal to the [[ileocecal valve]], is approximately two inches in length, and in majority of cases, affects age group <2yrs. In addition, the two most common types of ectopic [[Mucous membrane|mucosa]] found within the diverticulum are the [[Stomach|gastric]] and [[Pancreas|pancreatic]] types. Increased [[prevalence]] of Meckel's diverticulum is seen in children with umbilical [[Congenital disorder|malformations]], [[gastrointestinal tract]], [[Neurology|neurological]] and [[Circulatory system|cardiovascular]] defects. | ||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
===Prevalence=== | ===Prevalence=== | ||
*The prevalence of Meckel's diverticulum is approximately two percent of the general population. | *The [[prevalence]] of Meckel's diverticulum is approximately two percent of the general [[population]].<ref name="pmid17021300">{{cite journal |vauthors=Sagar J, Kumar V, Shah DK |title=Meckel's diverticulum: a systematic review |journal=J R Soc Med |volume=99 |issue=10 |pages=501–5 |year=2006 |pmid=17021300 |pmc=1592061 |doi=10.1258/jrsm.99.10.501 |url=}}</ref> | ||
*Increased prevalence of Meckel's diverticulum is seen in children with: | *Complications due to Meckel's diverticulum are only seen in about 5% of affected patients.<ref name="pmid18216533">{{cite journal |vauthors=Zani A, Eaton S, Rees CM, Pierro A |title=Incidentally detected Meckel diverticulum: to resect or not to resect? |journal=Ann. Surg. |volume=247 |issue=2 |pages=276–81 |year=2008 |pmid=18216533 |doi=10.1097/SLA.0b013e31815aaaf8 |url=}}</ref><ref name="pmid952346">{{cite journal |vauthors=Soltero MJ, Bill AH |title=The natural history of Meckel's Diverticulum and its relation to incidental removal. A study of 202 cases of diseased Meckel's Diverticulum found in King County, Washington, over a fifteen year period |journal=Am. J. Surg. |volume=132 |issue=2 |pages=168–73 |year=1976 |pmid=952346 |doi= |url=}}</ref> | ||
**Umbilical malformations | *Increased [[prevalence]] of Meckel's diverticulum is seen in children with: <ref name="pmid7362966">{{cite journal |vauthors=Simms MH, Corkery JJ |title=Meckel's diverticulum: its association with congenital malformation and the significance of atypical morphology |journal=Br J Surg |volume=67 |issue=3 |pages=216–9 |year=1980 |pmid=7362966 |doi= |url=}}</ref> | ||
**Gastrointestinal tract defects | **[[Umbilical]] [[Congenital disorder|malformations]] | ||
**Neurological and cardiovascular defects | **[[Gastrointestinal tract]] defects | ||
*In children with Meckel's diverticulum: | **[[Neurology|Neurological]] and [[Circulatory system|cardiovascular]] defects | ||
**60% of cases: symptomatic | *In children with Meckel's diverticulum:<ref name="pmid27064958">{{cite journal |vauthors=Francis A, Kantarovich D, Khoshnam N, Alazraki AL, Patel B, Shehata BM |title=Pediatric Meckel's Diverticulum: Report of 208 Cases and Review of the Literature |journal=Fetal Pediatr Pathol |volume=35 |issue=3 |pages=199–206 |year=2016 |pmid=27064958 |doi=10.3109/15513815.2016.1161684 |url=}}</ref> | ||
**60% of cases: [[symptomatic]] | |||
**40% of cases: incidental | **40% of cases: incidental | ||
** Most common [[Congenital abnormality|congenital anomaly]] of the [[gastrointestinal tract]] | |||
=== | ** No [[Genetics|genetic]] component | ||
* | * Rule of 2s applies to Meckel's diverticulum:<ref name="pmid21616248">{{cite journal |vauthors=Ruscher KA, Fisher JN, Hughes CD, Neff S, Lerer TJ, Hight DW, Bourque MD, Campbell BT |title=National trends in the surgical management of Meckel's diverticulum |journal=J. Pediatr. Surg. |volume=46 |issue=5 |pages=893–6 |year=2011 |pmid=21616248 |doi=10.1016/j.jpedsurg.2011.02.024 |url=}}</ref> | ||
* | ** Affects approximately 2 percent of the population | ||
** Male-to-female ratio of 2:1 | |||
** Located about two feet proximal to the [[ileocecal valve]] | |||
** Two inches in length | |||
** Mostly affects age group <2yrs | |||
** Two types of [[Mucous membrane|mucosa]] mostly: [[Stomach|gastric]] more common than [[Pancreas|pancreatic]] | |||
===Age=== | ===Age=== | ||
*Patients of all age groups may develop | *Patients of all age groups may develop Meckel's diverticulum. | ||
*The incidence of | *The [[incidence]] of Meckel's diverticulum decreases with age. | ||
* | *Meckel's diverticulum commonly affects individuals younger than two years of age, with more than thirty percent of cases being younger than 1 year.<ref name="pmid11333103">{{cite journal |vauthors=Yahchouchy EK, Marano AF, Etienne JC, Fingerhut AL |title=Meckel's diverticulum |journal=J. Am. Coll. Surg. |volume=192 |issue=5 |pages=658–62 |year=2001 |pmid=11333103 |doi= |url=}}</ref> | ||
*[ | *The most common [[symptom]] in children is [[obstruction]] and [[Lower gastrointestinal bleeding|lower GI bleeding]], while the most common presentation in adults is [[obstruction]].<ref name="pmid21616248">{{cite journal |vauthors=Ruscher KA, Fisher JN, Hughes CD, Neff S, Lerer TJ, Hight DW, Bourque MD, Campbell BT |title=National trends in the surgical management of Meckel's diverticulum |journal=J. Pediatr. Surg. |volume=46 |issue=5 |pages=893–6 |year=2011 |pmid=21616248 |doi=10.1016/j.jpedsurg.2011.02.024 |url=}}</ref> | ||
*[ | *Common presentation in children:<ref name="pmid21616248" /><ref name="pmid8863320">{{cite journal |vauthors=Pollack ES |title=Pediatric abdominal surgical emergencies |journal=Pediatr Ann |volume=25 |issue=8 |pages=448–57 |year=1996 |pmid=8863320 |doi= |url=}}</ref><ref name="pmid10943090">{{cite journal |vauthors=Anderson DJ |title=Carcinoid tumor in Meckel's diverticulum: laparoscopic treatment and review of the literature |journal=J Am Osteopath Assoc |volume=100 |issue=7 |pages=432–4 |year=2000 |pmid=10943090 |doi= |url=}}</ref><ref name="pmid24811048">{{cite journal |vauthors=Alemayehu H, Hall M, Desai AA, St Peter SD, Snyder CL |title=Demographic disparities of children presenting with symptomatic Meckel's diverticulum in children's hospitals |journal=Pediatr. Surg. Int. |volume=30 |issue=6 |pages=649–53 |year=2014 |pmid=24811048 |doi=10.1007/s00383-014-3513-y |url=}}</ref> | ||
**30%: [[Obstruction]] | |||
**27%: [[Bleeding]] | |||
**19%: [[Intussusception]] | |||
*Common presentation in the [[Infant|neonatal]] period: | |||
**58.3%: [[Bowel obstruction]] | |||
**33.3%: [[Pneumoperitoneum]] | |||
*Common manifestations in adults:<ref name="pmid21616248" /><ref name="pmid15776296">{{cite journal |vauthors=Ueberrueck T, Meyer L, Koch A, Hinkel M, Kube R, Gastinger I |title=The significance of Meckel's diverticulum in appendicitis--a retrospective analysis of 233 cases |journal=World J Surg |volume=29 |issue=4 |pages=455–8 |year=2005 |pmid=15776296 |doi=10.1007/s00268-004-7615-x |url=}}</ref> | |||
**[[Obstruction]] | |||
**[[Inflammation]] | |||
**[[Lower gastrointestinal bleeding|Lower GI bleeding]] | |||
===Race=== | ===Race=== | ||
* | *The racial predilection to Meckel's diverticulum is as follows: | ||
* | **63.4% white | ||
**16.4% Hispanic | |||
**4.7% African-American | |||
**3.9% Asian | |||
**11.6% other | |||
===Gender=== | ===Gender=== | ||
* | *Males are more commonly affected by Meckel's diverticulum than females. The male to female ratio is approximately 2 to 1. | ||
*The male to female ratio for development of complications in affected cases is 3:1. | |||
*The | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Latest revision as of 15:52, 8 January 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]
Overview
Meckel's diverticulum is present in approximately 2% of the population, as per the "Rule of 2s". This rule applies to patients with Meckel's diverticulum and states that it affects approximately 2 percent of the population with a male-to-female ratio of 2:1. It is mostly located about two feet proximal to the ileocecal valve, is approximately two inches in length, and in majority of cases, affects age group <2yrs. In addition, the two most common types of ectopic mucosa found within the diverticulum are the gastric and pancreatic types. Increased prevalence of Meckel's diverticulum is seen in children with umbilical malformations, gastrointestinal tract, neurological and cardiovascular defects.
Epidemiology and Demographics
Prevalence
- The prevalence of Meckel's diverticulum is approximately two percent of the general population.[1]
- Complications due to Meckel's diverticulum are only seen in about 5% of affected patients.[2][3]
- Increased prevalence of Meckel's diverticulum is seen in children with: [4]
- Umbilical malformations
- Gastrointestinal tract defects
- Neurological and cardiovascular defects
- In children with Meckel's diverticulum:[5]
- 60% of cases: symptomatic
- 40% of cases: incidental
- Most common congenital anomaly of the gastrointestinal tract
- No genetic component
- Rule of 2s applies to Meckel's diverticulum:[6]
- Affects approximately 2 percent of the population
- Male-to-female ratio of 2:1
- Located about two feet proximal to the ileocecal valve
- Two inches in length
- Mostly affects age group <2yrs
- Two types of mucosa mostly: gastric more common than pancreatic
Age
- Patients of all age groups may develop Meckel's diverticulum.
- The incidence of Meckel's diverticulum decreases with age.
- Meckel's diverticulum commonly affects individuals younger than two years of age, with more than thirty percent of cases being younger than 1 year.[7]
- The most common symptom in children is obstruction and lower GI bleeding, while the most common presentation in adults is obstruction.[6]
- Common presentation in children:[6][8][9][10]
- 30%: Obstruction
- 27%: Bleeding
- 19%: Intussusception
- Common presentation in the neonatal period:
- 58.3%: Bowel obstruction
- 33.3%: Pneumoperitoneum
- Common manifestations in adults:[6][11]
Race
- The racial predilection to Meckel's diverticulum is as follows:
- 63.4% white
- 16.4% Hispanic
- 4.7% African-American
- 3.9% Asian
- 11.6% other
Gender
- Males are more commonly affected by Meckel's diverticulum than females. The male to female ratio is approximately 2 to 1.
- The male to female ratio for development of complications in affected cases is 3:1.
References
- ↑ Sagar J, Kumar V, Shah DK (2006). "Meckel's diverticulum: a systematic review". J R Soc Med. 99 (10): 501–5. doi:10.1258/jrsm.99.10.501. PMC 1592061. PMID 17021300.
- ↑ Zani A, Eaton S, Rees CM, Pierro A (2008). "Incidentally detected Meckel diverticulum: to resect or not to resect?". Ann. Surg. 247 (2): 276–81. doi:10.1097/SLA.0b013e31815aaaf8. PMID 18216533.
- ↑ Soltero MJ, Bill AH (1976). "The natural history of Meckel's Diverticulum and its relation to incidental removal. A study of 202 cases of diseased Meckel's Diverticulum found in King County, Washington, over a fifteen year period". Am. J. Surg. 132 (2): 168–73. PMID 952346.
- ↑ Simms MH, Corkery JJ (1980). "Meckel's diverticulum: its association with congenital malformation and the significance of atypical morphology". Br J Surg. 67 (3): 216–9. PMID 7362966.
- ↑ Francis A, Kantarovich D, Khoshnam N, Alazraki AL, Patel B, Shehata BM (2016). "Pediatric Meckel's Diverticulum: Report of 208 Cases and Review of the Literature". Fetal Pediatr Pathol. 35 (3): 199–206. doi:10.3109/15513815.2016.1161684. PMID 27064958.
- ↑ 6.0 6.1 6.2 6.3 Ruscher KA, Fisher JN, Hughes CD, Neff S, Lerer TJ, Hight DW, Bourque MD, Campbell BT (2011). "National trends in the surgical management of Meckel's diverticulum". J. Pediatr. Surg. 46 (5): 893–6. doi:10.1016/j.jpedsurg.2011.02.024. PMID 21616248.
- ↑ Yahchouchy EK, Marano AF, Etienne JC, Fingerhut AL (2001). "Meckel's diverticulum". J. Am. Coll. Surg. 192 (5): 658–62. PMID 11333103.
- ↑ Pollack ES (1996). "Pediatric abdominal surgical emergencies". Pediatr Ann. 25 (8): 448–57. PMID 8863320.
- ↑ Anderson DJ (2000). "Carcinoid tumor in Meckel's diverticulum: laparoscopic treatment and review of the literature". J Am Osteopath Assoc. 100 (7): 432–4. PMID 10943090.
- ↑ Alemayehu H, Hall M, Desai AA, St Peter SD, Snyder CL (2014). "Demographic disparities of children presenting with symptomatic Meckel's diverticulum in children's hospitals". Pediatr. Surg. Int. 30 (6): 649–53. doi:10.1007/s00383-014-3513-y. PMID 24811048.
- ↑ Ueberrueck T, Meyer L, Koch A, Hinkel M, Kube R, Gastinger I (2005). "The significance of Meckel's diverticulum in appendicitis--a retrospective analysis of 233 cases". World J Surg. 29 (4): 455–8. doi:10.1007/s00268-004-7615-x. PMID 15776296.