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Japanese Journal of Radiology May 2016Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. It is a true diverticulum containing all layers of the intestinal wall and... (Review)
Review
Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. It is a true diverticulum containing all layers of the intestinal wall and identified as a saccular, blind-ending structure located on the antimesenteric border of the distal ileum. Most patients remain asymptomatic during their lifetime. Symptomatic cases are nonspecific and can present as small-bowel obstruction, diverticulitis, perforation, gastrointestinal bleeding, and rarely, a neoplasm. Therefore, the radiological diagnosis is of paramount important for proper patient management.
Topics: Angiography; Diagnostic Imaging; Humans; Ileum; Meckel Diverticulum; Radionuclide Imaging; Tomography, X-Ray Computed; Ultrasonography
PubMed: 26932405
DOI: 10.1007/s11604-016-0530-x -
Journal of Medical Imaging and... Apr 2017Meckel's diverticulum is the most frequent congenital malformation of the gastrointestinal tract, occurring in 2% of the general population. Meckel's diverticulum is... (Review)
Review
Meckel's diverticulum is the most frequent congenital malformation of the gastrointestinal tract, occurring in 2% of the general population. Meckel's diverticulum is usually asymptomatic and found incidentally. However, the lifetime risk of complications is 4-40%. In this essay, we describe the clinical and imaging findings in 12 cases of Meckel's diverticula with complications over a 5-year period, which were confirmed pathologically. The major complications of Meckel's diverticulum include gastrointestinal bleeding, bowel obstruction, perforation and inflammation. Small bowel follow-through (SBFT), computed tomography (CT) including CT enterography and RI scintigraphy can be used to show typical imaging features of Meckel's diverticulum and its complications. Knowledge of the clinical and radiologic findings of Meckel's diverticulum can aid in the early and accurate diagnosis of this anomaly and its complications.
Topics: Diagnostic Imaging; Gastrointestinal Tract; Humans; Meckel Diverticulum
PubMed: 27492813
DOI: 10.1111/1754-9485.12505 -
Pediatric Radiology Mar 2023Meckel diverticulum, the most common congenital anomaly of the gastrointestinal tract, results from the aberrant involution of the omphalomesenteric duct and accounts... (Review)
Review
Meckel diverticulum, the most common congenital anomaly of the gastrointestinal tract, results from the aberrant involution of the omphalomesenteric duct and accounts for more than 50% of unexplained lower gastrointestinal bleeding in the pediatric population. The most accurate imaging tool to identify a Meckel diverticulum containing ectopic gastric mucosa is the Technetium-99m pertechnetate Meckel scan, a scintigraphic study with a reported accuracy of 90% in the pediatric population. In addition to depicting a Meckel diverticulum with ectopic gastric mucosa, careful attention to the normal biodistribution of the radiotracer can lead to the identification of unexpected pathology with implications for patient management. This article serves to review the embryological origin and anatomical features of Meckel diverticulum, highlight the role of scintigraphy in evaluating Meckel diverticulum, and discuss the proper imaging technique when performing this test. We will focus on pitfalls that can lead to an erroneous diagnosis as well as incidental findings that can affect patient management.
Topics: Child; Humans; Meckel Diverticulum; Tissue Distribution; Radiopharmaceuticals; Radionuclide Imaging; Gastrointestinal Hemorrhage; Musculoskeletal Diseases; Sodium Pertechnetate Tc 99m
PubMed: 36323958
DOI: 10.1007/s00247-022-05527-z -
Journal of Visceral Surgery Sep 2017Meckel's diverticulum (MD) is the most common gastro-intestinal congenital malformation (approximately 2% in the overall population). The lifetime risk of related... (Review)
Review
Meckel's diverticulum (MD) is the most common gastro-intestinal congenital malformation (approximately 2% in the overall population). The lifetime risk of related complications is estimated at 4%. These include gastro-intestinal bleeding, obstruction or diverticular inflammation. Diagnosis is difficult and rarely made, and imaging, especially in the case of complicated disease, is often not helpful; however exploratory laparoscopy is an important diagnostic tool. The probability of onset of complication decreases with age, and the diagnosis of MD in the adult is therefore often incidental. Resection is indicated in case of complications but remains debatable when MD is found incidentally. According to an analysis of large series in the literature, surgery is not indicated in the absence of risk factors for complications: these include male gender, age younger than 40, diverticulum longer than two centimetres and the presence of macroscopically mucosal alteration noted at surgery. Resection followed by anastomosis seems preferable to wedge resection or tangential mechanical stapling because of the risk of leaving behind abnormal heterotopic mucosa.
Topics: Adult; Humans; Laparoscopy; Meckel Diverticulum
PubMed: 28698005
DOI: 10.1016/j.jviscsurg.2017.06.006 -
Seminars in Nuclear Medicine Nov 2023Imaging of gastrointestinal bleeding crucial in the diagnosis of occult gastrointestinal bleeding. Gastrointestinal bleeding scintigraphy is a well-established study to... (Review)
Review
Imaging of gastrointestinal bleeding crucial in the diagnosis of occult gastrointestinal bleeding. Gastrointestinal bleeding scintigraphy is a well-established study to aid localisation of gastrointestinal bleeding site. This article discusses about the use of gastrointestinal bleeding scintigraphy in its current practice with emphasis on radiopharmaceutical, imaging techniques, interpretation and pitfalls. There is also discussion on the use of Single Photon Emission Computed Tomography-Computed Tomography (SPECT-CT) within this method of scintigraphy. Meckel's diverticulum is known to be a frequent source of bleeding, mainly in children. It is also know that nuclear medicine imaging can help with Meckel's diverticulum identification. This article also discusses about the technique, imaging, interpretation and SPECT-CT usage for Meckel's diverticulum imaging.
Topics: Child; Humans; Meckel Diverticulum; Diagnostic Imaging; Radionuclide Imaging; Gastrointestinal Hemorrhage; Nuclear Medicine
PubMed: 37451934
DOI: 10.1053/j.semnuclmed.2023.06.002 -
AJR. American Journal of Roentgenology Nov 2017Meckel diverticulum may become symptomatic if it is complicated by hemorrhage, intestinal obstruction, diverticulitis, or tumor. Although classically described in... (Review)
Review
OBJECTIVE
Meckel diverticulum may become symptomatic if it is complicated by hemorrhage, intestinal obstruction, diverticulitis, or tumor. Although classically described in children, it is often missed in adults because of lack of suspicion and difficulty in detection. The purpose of this article is to review the imaging findings and management of Meckel diverticulum and its complications.
CONCLUSION
Although it is infrequently encountered incidentally, Meckel diverticulum should be considered especially when interpreting examinations for abdominal pain, small-bowel obstruction, and gastrointestinal bleeding.
Topics: Adult; Humans; Meckel Diverticulum
PubMed: 28834452
DOI: 10.2214/AJR.17.18088 -
Journal of Gastrointestinal Surgery :... Dec 2017A Meckel's diverticulum is a vestigial remnant present in approximately 2% of the population. Fewer than 10% of patients with a Meckel's diverticulum develop clinical...
A Meckel's diverticulum is a vestigial remnant present in approximately 2% of the population. Fewer than 10% of patients with a Meckel's diverticulum develop clinical complications, and such findings are exceedingly rare in the geriatric population. We present a case of perforated Meckel's diverticulitis with a fistulous tract involving the anterior abdominal wall in an 85-year-old male.
Topics: Abdominal Wall; Aged, 80 and over; Diverticulitis; Humans; Ileal Diseases; Intestinal Fistula; Intestinal Perforation; Male; Meckel Diverticulum
PubMed: 28744739
DOI: 10.1007/s11605-017-3511-1 -
Jornal de Pediatria 2023Meckel diverticulum (MD) is a common malformation of the digestive tract, often accompanied by serious complications. It is important to find safe and effective... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Meckel diverticulum (MD) is a common malformation of the digestive tract, often accompanied by serious complications. It is important to find safe and effective diagnostic methods for screening MD. The aim of this study was to evaluate the effectiveness of a technetium-99m (Tc-99m) scan for pediatric bleeding MD.
METHODS
The authors conducted a systematic review of studies published in PubMed, Embase, and Web of Science before 1 January 2023. Studies based on PICOS were included in this systematic review. The flow chart was made by PRISMA software. The quality of included studies was assessed by RevMan5 software (QUADAS-2: Quality Assessment of Diagnostic Accuracy Studies-2). The sensitivity, specificity, and other measurements of accuracy were pooled using Stata/SE 12.0 software.
RESULTS
Sixteen studies with 1115 children were included in this systematic review. A randomized-effects model was used for the meta-analysis because of significant heterogeneity. The combined sensitivity and specificity were 0.80 [Confidence Interval (95% CI, 0.73-0.86) and 0.95 (95% CI, 0.86-0.98)], respectively. The area under the curve (AUC) was 0.88 (95% CI, 0.85-0.90). Publication bias (Begg's test p = 0.053) was observed.
CONCLUSION
Tc-99m scan has high specificity, but moderate sensitivity, which is always influenced by some factors. Hence, the Tc-99m scan has some limitations in the diagnosis of pediatric bleeding MD.
Topics: Child; Humans; Technetium; Meckel Diverticulum; Radionuclide Imaging; Gastrointestinal Hemorrhage; Sensitivity and Specificity
PubMed: 37277097
DOI: 10.1016/j.jped.2023.03.009 -
BMJ Case Reports Mar 2021Meckel's diverticulum is the most common intestinal congenital defect, its prevalence is 0.2%-4.0% and it occurs more commonly in children younger than 2-year old with...
Meckel's diverticulum is the most common intestinal congenital defect, its prevalence is 0.2%-4.0% and it occurs more commonly in children younger than 2-year old with intestinal bleeding and abdominal pain. Perforation in the elderly is very rare with no more than 35 articles reported worldwide. Here we report the case of a 62-year-old man who was admitted to hospital with a history of acute abdominal pain with a 20-day onset. The patient was treated with laparotomy and 30 cm ileal resection was performed for an 8×5 cm perforated ileum tumour at 50 from ileocecal valve with a side-to-side mechanical anastomosis for reconstruction. Having morbidity Clavien-Dindo scale I in postsurgical and good outcome in 6-month follow-up. Meckel's diverticulum is an infrequent pathology in paediatric and even rarer in adult population, however, it is always important to keep in mind how to act when is seen either as a finding or as a complication.
Topics: Abdominal Pain; Adult; Aged; Child; Child, Preschool; Gastrointestinal Hemorrhage; Humans; Ileocecal Valve; Laparotomy; Male; Meckel Diverticulum; Middle Aged
PubMed: 33782062
DOI: 10.1136/bcr-2020-237840 -
Pediatric Emergency Care Oct 2021Children with abdominal pain are frequently seen in emergency departments. Physicians and parents worry about appendicitis; physicians are also concerned about...
Children with abdominal pain are frequently seen in emergency departments. Physicians and parents worry about appendicitis; physicians are also concerned about intussusception and bowel obstruction in patients with previous surgical procedures. Sometimes the patient is ill, and the diagnosis is elusive. In a 6-month period at our pediatric emergency department with an annual census of 57,400 patients, we cared for 4 patients who presented with abdominal pain due to complications of Meckel's diverticulum. None presented with painless rectal bleeding, the complication of which physicians are most aware. We are reporting these patients to raise awareness of Meckel's diverticulum as a cause of acute abdomen in children. Meckel's diverticulum may masquerade as appendicitis, an abdominal mass, intussusception, or a complication of severe constipation.
Topics: Abdomen, Acute; Abdominal Pain; Child; Humans; Intestinal Obstruction; Intussusception; Meckel Diverticulum
PubMed: 34507344
DOI: 10.1097/PEC.0000000000002537