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Süleyman Çelebi, Başak Erginel, Seyithan Özaydın, Cemile Başdaş, Esra Polat, Serdar Sander
(Deprtment of Pediatric Surgery, Istanbul University, Istanbul, Turkey)
Med Sci Hypotheses 2017; 4:24-28
The symptomatic presentation of Meckel’s diverticulum (MD) depends on a person’s age, sex, and presence or absence of ectopic gastric tissue. There are no differences in the prevalence of asymptomatic MD between males and females; however, symptomatic MD has a distinct male predominance, with a male-to-female ratio ranging from 2: 1 to 5: 1 in children. Furthermore, if the ectopic tissue contains gastric mucosa, MD has a greater chance of becoming symptomatic.
Studies have shown that acid secretion is more likely to occur in male infants compared to female infants. In adults, men are known to have a higher level of acid production compared to women. Peptic ulcers (PU) are more common in males due to higher acid secretion, and gastric tissues are affected by gastrin secretion in both conditions. MD is typically accompanied by ectopic gastric tissue, and could therefore be affected by gastrin and acid secretion in a similar manner to PU. Some of the major complications of MD are diverticulitis, ulcers, and bleeding from adjacent ectopic gastric tissue, and such complications resemble PU. PU also has male-to-female ratios ranging from 2: 1 to 5: 1, which is similar to that of MD. Since the secretion of both gastrin and acid decrease with age, symptomatic presentation of MD also declines with age.
Therefore, we hypothesized that higher gastrin and acid levels in males affect the ectopic gastric mucosa and lead to an increase in MD symptoms, which results in increased incidence of MD in males.
Keywords: Gastrins, Meckel Diverticulum, Vitelline Duct