Meckel's diverticulum: A challenging diagnosis.

Objectives: This single-center, cross-sectional study aims to elucidate the clinical presentation, diagnostic evaluation, and outcomes in a subset of pediatric patients with atypical and/or challenging presentations of Meckel's diverticulum.

Methods: We conducted a single-center cross-sectional study on children diagnosed with Meckel's diverticulum at Children's Health in Dallas, Texas between 2010 and 2022. We identified 11 patients aged 0-17-years-old with confirmed Meckel's diverticulum who presented with atypical symptoms and/or a challenging diagnostic course. Patient demographics, symptoms at presentation, diagnostic workup, time to diagnosis, management, and outcomes were collected. Descriptive statistics were utilized.

Results: Eleven patients (n = 8, 73% male) were included in the study with an average age of 10.5 years (range: 1-17 years). The mean time interval from initial presentation of symptoms to diagnosis was 8 months (range: 0-33 months). Barriers to diagnosis of Meckel's diverticulum identified in our study included atypical presentations, negative or nonconfirmatory Meckel scan results, negative surgical findings, and competing differential diagnoses.

Conclusion: Meckel's diverticulum is a challenging diagnosis and should be considered even if initial evaluation is negative as certain patients exhibit atypical presentations that necessitate surgical intervention for diagnosis.