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Intestinal obstruction caused by mesodiverticular band in children: a cohort study

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Abstract

Objective

To explore clinical characteristics, pathogenesis, diagnosis and treatment of intestinal obstruction due to mesodiverticular band (MDB) in children in a single center in China.

Methods

The clinical data of 20 children with acute intestinal obstruction due to MDB between 1998 and 2020 were retrospectively analyzed.

Results

The male-to-female ratio was 14:6 in 20 cases. Except one case of 7-month pregnant stillbirth, the cases were aged from 7 days to 14 years, at the median age of 4.31 years. The common symptoms were vomiting, abdominal pain and/or abdominal distension. About 40% (8/20) of patients had both MDB and Meckel's Diverticulum (MD), while 60% (12/20) of patients had MDB only. Only one case died because of total colonic aganglionosis, while other children recovered after surgery treatment. MDB led to the strangulation of necrotic bowel in six cases, intestinal perforation in one case, and intestinal rupture in one case. Pathologic examination showed thick-walled arteries and or thick venous vascular structures in the cord. All cases had no complications during 1-year follow-up.

Conclusion

MDB results from the remnant of vitelline vessel, and often causes acute intestinal obstruction without special clinical symptoms. Unexplained abdominal pain and distension without surgery history should be paid attention, especially for strangulated intestinal obstruction. Timely surgical exploration is beneficial to avoid intestinal necrosis or even sudden death, and the pathological examination is important for the diagnosis.

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Data availability

All data are available upon request to correspondence authors.

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Acknowledgements

This work was supported by The Science and Technology Innovation Commission of Shenzhen (No. JCYJ20190809145809375), Guangdong Basic and Applied Basic Research Foundation (No. 2021A1515010009) and Educational Commission of Guangdong Province of China (No. 2020KQNCX011). We thank Yitong Zhang for help with making figures.

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Authors and Affiliations

  1. Department of Pediatric Surgery, **shan District Maternal & Child Healthcare Hospital of Shenzhen, **shan General Hospital of Southern Medical University, Shenzhen, 518118, Guangdong, China

    Xuan Zhang, Hongyan **, Jiuhong Zhang, Ke Li, Danli Li, Meirong Huang & Xuewu Jiang

  2. Department of Pediatric Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China

    Xuan Zhang, Ke Li, Kaihong Chen, Jianhong Li & Xuewu Jiang

  3. Department of Pediatric Surgery, Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), Shenzhen, Guangdong, China

    Shouxing Duan

  4. Department of Pathology Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China

    Haihua Huang

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  1. Xuan Zhang
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  2. Hongyan **
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  3. Jiuhong Zhang
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  4. Ke Li
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  5. Danli Li
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  8. Meirong Huang
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  9. Haihua Huang
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  10. Jianhong Li
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  11. Xuewu Jiang
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Contributions

XZ: designed the study, HP and JZ: collected and analyzed the data, KL, JL, DL, KC, SD, MH, HH, JL and XJ: provided support for data collection and analysis. All authors read and approved the manuscript.

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Correspondence to Xuan Zhang or Xuewu Jiang.

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Zhang, X., **, H., Zhang, J. et al. Intestinal obstruction caused by mesodiverticular band in children: a cohort study. Pediatr Surg Int 39, 163 (2023). https://doi.org/10.1007/s00383-023-05443-9

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  • DOI: https://doi.org/10.1007/s00383-023-05443-9

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