Clinico-Pathology Study of Vitellointestinal Remnants in Children

Abstract

Background: Vitellointestinal duct (VID) remnants are among the most common congenital anomalies of the gastrointestinal tract, with Meckel's diverticulum being the most frequent manifestation. Their clinical presentation varies widely, and symptomatic lesions often require surgical intervention.

Objectives: To study the clinicopathological features, modes of presentation, complications, and histopathological findings of vitellointestinal duct remnants in children.

Methods: A retrospective clinicopathological study of children treated for vitellointestinal duct remnants at the Department of Pediatric Surgery, S.A.T. Hospital, Government Medical College, Thiruvananthapuram. Clinical records and histopathological findings were analyzed to evaluate age distribution, sex, presenting symptoms, operative findings, and associated heterotopic mucosa.

Results: Among the symptomatic cases, intestinal obstruction was the most common presentation, followed by inflammation, while lower gastrointestinal bleeding accounted for approximately 13% of presentations. About half of the cases presented before two years of age, with a male predominance. Heterotopic mucosa was identified in 16.54% of symptomatic patients, a lower proportion than reported in many previous studies.

Conclusion: The study demonstrated differences in the presentation of Meckel's diverticulum compared with earlier reports, with intestinal obstruction being more common than rectal bleeding. Because complicated Meckel's diverticulum is associated with significant morbidity and mortality, the authors recommend resection of asymptomatic Meckel's diverticula discovered incidentally during laparotomy.