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Meckel's Diverticulum
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Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Ponsky would use a high Meckel score to go straight to laparoscopy, skipping the Meckel scan, because even with a negative scan he would still suspect Meckel diverticulum. — Todd Ponsky, Journal of Pediatric Surgery Article Review: September 2021 · 5:40
Journal of Pediatric Surgery Article Review: September 2021
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We're highlighting three articles from the September 2021 issue of the Journal of Pediatric Surgery. We review the articles with Dr. Mikko Pakarinen (JPS Editor for Europe), Dr. Todd Ponsky, and two of the authors from one of the articles (
podcast11:16 · Oct 2021
Journal of Pediatric Surgery Article Review: September 2021
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video11:16 · Jun 2026
When performing laparoscopic Meckel's resection with stapling, pulling on the diverticulum can distort anatomy and lead to encroachment onto the bowel, potentially causing stricture. Bleeding Meckel's Diverticulum: Update Course 2015 · 3:32
Bleeding Meckel's Diverticulum: Update Course 2015
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During the 3rd Annual Stay Current in Pediatric Surgery Update Course in 2015, Dr. Nicholas Bruns leads the discussion on management ofbleeding Meckel's Diverticulum. Topics discussed include use of proton pump inhibitors for bleeding cessa
video4:26 · Jan 2019
Expert statements from the recordings in this collection.
Journal of Pediatric Surgery Article Review: September 2021
In the Chinese randomized trial, the early feeding group started feeds at 2 days compared to 6 days for the traditional feeding group.
The Chinese trial found no significant difference between early and traditional feeding groups in length of stay, time to full feeds, postoperative complications, 30-day mortality, or 30-day readmissions.
Although there is evidence that early feeding in adult patients after intestinal surgery is beneficial, the Chinese study authors did not find any benefit in neonates.
Mikko Pakarinen2:53
In the early feeding group, patients did not have a decompressing nasogastric tube.
Todd Ponsky3:11
The early feeding group was fed through the NG tube left to gravity, not decompressing the stomach after anastomosis.
Todd Ponsky3:46
Ponsky concludes that nasogastric tubes are not needed after a baby anastomosis based on the Chinese trial data.
The Meckel diverticulum study examined patients under age 18 who presented with hematochezia and determined which presenting factors predict Meckel diverticulum, creating a risk score.
Pakarinen states that blood in stool causing a decrease in hemoglobin has always been a red flag sign for Meckel diverticulum in his experience.
Ponsky would use a high Meckel score to go straight to laparoscopy, skipping the Meckel scan, because even with a negative scan he would still suspect Meckel diverticulum.
The Meckel score would help Ponsky potentially skip the Meckel scan in certain subsets of patients, representing a practice change.
The Cincinnati perianal Crohn's study included all children aged 0-18 years living within a 15-mile radius of Cincinnati Children's who presented with perianal disease.
Julian Goddard8:16
The study also reviewed all children within a 50-mile radius diagnosed with Crohn disease.
Julian Goddard8:42
Overall, 3% of children presenting with perianal symptoms were diagnosed with Crohn disease.
Julian Goddard9:02
No children under age 1 in the study ended up having Crohn disease within the study period.
Julian Goddard9:11
Higher rates of Crohn disease were seen in older children, particularly over age 10.
Iris Limbuel9:18
Many patients in the study had fissures, which are very common in children.
Mikko Pakarinen9:40
The study included patients whose perianal symptoms were managed as outpatients, who may never have been seen by the surgical team.
Iris Limbuel9:54
Ponsky concludes that under age 10, workup for Crohn disease is not needed for perianal symptoms, but over age 10 it should be performed.
Ponsky previously thought Crohn disease most commonly presented with GI symptoms like abdominal pain and diarrhea, but learned that quite a few kids present with perirectal abscess.
Ponsky has been sending children with perirectal abscess to GI for colonoscopy and has been finding Crohn disease.
Todd Ponsky10:27
In the Chinese trial, the early feeding group started feeds at 2 days compared to 6 days in the traditional feeding group
There was no significant difference between early and traditional feeding groups in length of stay, time to full feeds, postoperative complications, 30-day mortality, or 30-day readmissions
Although there is evidence that early feeding in adult patients after intestinal surgery is beneficial, the authors didn't find any benefit in neonates
Mikko Pakarinen2:37
In the early feeding group, patients did not have a decompressing nasogastric tube, suggesting nasogastric decompression is not needed after neonatal intestinal anastomosis
The Utah study created a risk score to predict Meckel's diverticulum in patients presenting with hematochezia
Babies with blood in their stool causing a decrease in hemoglobin has always been a red flag sign for Meckel's diverticulum
Mikko Pakarinen5:10
Todd Ponsky suggests using the Meckel's score to go straight to laparoscopy in high-score patients, skipping the Meckel scan, because even with a negative scan he would still suspect Meckel's diverticulum
The Cincinnati study included all children aged 0-18 years within a 15-mile radius who presented with perianal disease
Iris Lim Butel7:23
Only 3% of children presenting with perianal symptoms were diagnosed with Crohn's disease
Iris Lim Butel8:51
No children under the age of 1 year with perianal abscess ended up having Crohn's disease within the study period
Iris Lim Butel9:02