{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T06:11:37Z","timestamp":1778825497764,"version":"3.51.4"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017949","name":"Health Commission of Shanxi Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017949","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Meckel's diverticulum (MD) is the most common congenital gastrointestinal malformation in children, with gastrointestinal bleeding being the most frequent associated complication. While existing studies have primarily focused on ectopic mucosa and diverticulum length as predictors of complications, no research has specifically evaluated the association between diverticulum width and MD symptoms, particularly gastrointestinal bleeding. This study aimed to determine whether diverticulum width is an independent predictor of gastrointestinal bleeding risk in symptomatic patients, and to evaluate its potential utility for individualized surgical decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study investigated the association between diverticulum width and the risk of gastrointestinal bleeding in children with symptomatic Meckel's diverticulum. To do this, we conducted an in-depth analysis of the relationship between diverticulum width and gastrointestinal bleeding risk using multivariate logistic regression models, generalised additive models and two-stage linear regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 310 paediatric patients with symptomatic Meckel's diverticulum were ultimately enrolled based on inclusion and exclusion criteria. After adjusting for potential confounding factors, diverticular width was found to be an independent predictor of gastrointestinal bleeding risk. A inverted U-shaped relationship was observed between diverticular width and gastrointestinal bleeding risk, with the highest risk occurring at approximately 1.25\u2005cm. Furthermore, a significant interaction was identified between ectopic mucosa and diverticular width in modulating gastrointestinal bleeding risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In paediatric patients with symptomatic Meckel's diverticulum, the width of diverticula shows an inverse U-shaped relationship with the risk of gastrointestinal bleeding, with the highest risk occurring at around 1.25\u2005cm. The presence of ectopic mucosa modulates this relationship through an interactive effect. These findings could help to improve risk stratification and inform surgical decision-making in cases of Meckel's diverticulum.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1774572","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:41:46Z","timestamp":1778823706000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Inverted U-shaped relationship between diverticular width and gastrointestinal bleeding in symptomatic Meckel's diverticulum children: a retrospective single-center study"],"prefix":"10.3389","volume":"14","author":[{"given":"Xufeng","family":"Gao","sequence":"first","affiliation":[{"name":"Department of General Surgery, Children\u2019s Hospital of Shanxi","place":["Taiyuan, Shanxi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiangqiang","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Children\u2019s Hospital of Shanxi","place":["Taiyuan, Shanxi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Children\u2019s Hospital of Shanxi","place":["Taiyuan, Shanxi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongwei","family":"Xi","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Children\u2019s Hospital of Shanxi","place":["Taiyuan, Shanxi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1007\/s00383-025-06197-2","article-title":"Diverse clinical features of symptomatic Meckel\u2019s diverticulum: a multicenter study of 151 consecutive pediatric patients from the western Balkans","volume":"41","author":"Zvizdic","year":"2025","journal-title":"Pediatr Surg Int"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1617214","DOI":"10.3389\/fped.2025.1617214","article-title":"Comparison of clinical manifestations and immunoreactivities of Meckel\u2019s diverticulum with and without gastric heteroplasia","volume":"13","author":"Zhang","year":"2025","journal-title":"Front Pediatr"},{"key":"B3","doi-asserted-by":"publisher","first-page":"111602","DOI":"10.1016\/j.ijscr.2025.111602","article-title":"Unveiling the hidden cause behind painless lower gastrointestinal bleeding in an adult - Meckel\u2019s diverticulum: a case report","volume":"133","author":"Jha","year":"2025","journal-title":"Int J Surg Case Rep"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e84601","DOI":"10.7759\/cureus.84601","article-title":"Severe rectal hemorrhage in adolescents: an unusual presentation of Meckel\u2019s diverticulum","volume":"17","author":"Matarneh","year":"2025","journal-title":"Cureus"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1327545","DOI":"10.3389\/fsurg.2023.1327545","article-title":"Meckel\u2019s diverticulum: analysis of 27 cases in an adult population","volume":"10","author":"Hern\u00e1ndez","year":"2023","journal-title":"Front Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1111\/j.1445-1433.2004.03191.x","article-title":"Diverticulectomy is inadequate treatment for short Meckel\u2019s diverticulum with heterotopic mucosa","volume":"74","author":"Varcoe","year":"2004","journal-title":"ANZ J Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"6912043","DOI":"10.1155\/2022\/6912043","article-title":"Emergency presentations of Meckel\u2019s diverticulum in adults","volume":"2022","author":"Mohammed","year":"2022","journal-title":"Surg Res Pract"},{"key":"B8","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1097\/01.sla.0000154270.14308.5f","article-title":"Meckel diverticulum: the mayo clinic experience with 1476 patients (1950-2002)","volume":"241","author":"Park","year":"2005","journal-title":"Ann Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"6154","DOI":"10.3748\/wjg.v27.i36.6154","article-title":"Inverted Meckel\u2019s diverticulum diagnosed using capsule endoscopy: a case report","volume":"27","author":"El Hajra Mart\u00ednez","year":"2021","journal-title":"World J Gastroenterol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"103178","DOI":"10.1016\/j.eclinm.2025.103178","article-title":"Dynamics of serum testosterone and biological aging in men: insights from Chinese, American, and British populations","volume":"82","author":"Huang","year":"2025","journal-title":"EClinicalMedicine"},{"key":"B11","doi-asserted-by":"publisher","first-page":"55","DOI":"10.3389\/fsurg.2018.00055","article-title":"Meckel\u2019s diverticulum in adults: surgical concerns","volume":"5","author":"Blouhos","year":"2018","journal-title":"Front Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1016\/j.jpedsurg.2017.11.059","article-title":"Multifaceted behavior of Meckel\u2019s diverticulum in children","volume":"53","author":"Chen","year":"2018","journal-title":"J Pediatr Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1007\/s00383-020-04673-5","article-title":"Laparoscopic diverticulectomy or laparoscopic-assisted resection of symptomatic Meckel diverticulum in children? 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