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Experience With 217 Childhood Cases

Dennis W. Vane, MD; Karen W. West, MD; Jay L. Grosfeld, MD

Arch Surg. 1987;122(5):542-547.

Abstract
• Of 217 children with vitelline duct anomalies, 85 (40%) had symptomatic lesions (mean age, 2.4 years). Forty-eight patients presented with rectal bleeding; 28, with intestinal obstruction; five, with abdominal pain; and four, with bilious umbilical drainage. An asymptomatic Meckel's diverticulum was discovered incidentally at laparotomy in 132 children. Surgical therapy included bowel resection in nine patients with volvulus, four with intussusception, seven with bleeding, three with vitelline cysts, and one with a perforation. Diverticulectomy was performed in 189 cases, and excision of a patent vitelline duct was accomplished in four neonates with umbilical drainage. Ectopic gastric mucosa was present in all 48 patients with bleeding and in four of five with inflammation but in only two asymptomatic specimens. More than one third of the cases were symptomatic and presented in younger patients. This suggests that elective resection of asymptomatic vitelline remnants in early childhood is reasonable at the time of laparotomy for other conditions.

(Arch Surg 1987;122:542-547)

Author Affiliations
From the Section of Pediatric Surgery, Department of Surgery, James Whitcomb Riley Hospital for Children, Indiana University Medical Center, Indianapolis.

Footnotes
Accepted for publication Jan 9, 1987.

Read before the 94th Annual Meeting of the Western Surgical Association, Dearborn, Mich, Nov 16, 1986.

Reprint requests to Department of Surgery, James Whitcomb Riley Hospital for Children, 702 Barnhill Dr (K21), Indianapolis, IN 46223 (Dr Grosfeld).

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