-
Fetal and Pediatric Pathology 2016We report a review of 208 cases of Meckel's diverticulum among pediatric patients from one single institution. One of the aims of this report is to highlight the... (Review)
Review
We report a review of 208 cases of Meckel's diverticulum among pediatric patients from one single institution. One of the aims of this report is to highlight the different diagnostic modalities of Meckel's diverticulum since a majority of cases is undiagnosed prior to surgery. Our review shows 58 cases containing gastric and/or pancreatic heterotopic tissue, including two unique cases. The first case reported is a desmoid tumor arising at the tip of diverticulum, a case that, to our knowledge, has not been previously reported. The second case involves a female patient appearing with an acute abdomen thought to be appendicitis, instead surgery revealed a diverticulum arising from the ileum. The cause of acute abdomen was due to gonococcal infection. In conclusion, we hope that this large series of Meckel's cases will enrich our readers on the differential diagnosis and preoperative diagnostic techniques of Meckels' diverticulum.
Topics: Abdomen, Acute; Adolescent; Appendicitis; Child; Diagnosis, Differential; Female; Humans; Meckel Diverticulum; Pancreas; Prevalence
PubMed: 27064958
DOI: 10.3109/15513815.2016.1161684 -
Chirurgia (Bucharest, Romania : 1990) 2016Meckel's Diverticulum is the most common congenital malformation of the gastrointestinal tract with a prevalence of 2 % in the general population, being twice as common...
Meckel's Diverticulum is the most common congenital malformation of the gastrointestinal tract with a prevalence of 2 % in the general population, being twice as common and symptomatic in males. Not seldom is the diagnosis made incidentally, upon laparotomy for other intra-abdominal conditions, namely acute appendicitis. Simple Diverticulectomy is the surgical treatment of choice. We present the case of S.M., a 38 year-old male who was admitted to the Surgery Department of the Bucharest Clinical Emergency Hospital for sudden onset of initially periumbilical pain, which later migrated and localized in the right iliac fossa (RIF) accompanied by vomiting after the onset of pain, approximately 24 hours prior to admission. Examination of the abdomen revealed localized peritoneal signs. An Alvarado score of 8 was calculated. A laparotomy for appendectomy was performed, upon which the sigmoid colon was found in the RIF, and an appendix of 10 cm in length was visualized in a subhepatic, ascendant position. At a distance of 90 cm from the ileocecal valve, a Meckel's Diverticulum with dimensions of 7/4 cm was discovered. A retrograde appendectomy was performed first, along with a simple diverticulectomy, with the use of a TA 30 mm stapler. The operative time was 90 minutes without intraoperative complications, and an uneventful postoperative recovery, culminating with discharge of the patient on the fifth postoperative day. Despite its high prevalence, Meckel's Diverticulum still represents a diagnostic challenge, especially in the adult population, notably in asymptomatic patients. Moreover, ectopic gastric or pancreatic tissue, present in 50% of the cases, leads to a vast array of differential diagnoses. Due to its numerous life-threatening complications such as bleeding, intestinal obstruction, volvulus, intussusception, diverticulitis, fistulization and perforation, accurate diagnosis and timely treatment is crucial.
Topics: Abdominal Pain; Acute Disease; Adult; Appendectomy; Appendicitis; Diagnosis, Differential; Diverticulitis; Emergencies; Humans; Incidental Findings; Male; Meckel Diverticulum; Surgical Stapling; Treatment Outcome; Vomiting
PubMed: 27452941
DOI: No ID Found -
JAAPA : Official Journal of the... Sep 2015Meckel diverticulum is an uncommon congenital abnormality of the gastrointestinal (GI) tract that usually remains asymptomatic throughout a patient's lifetime. However,... (Review)
Review
Meckel diverticulum is an uncommon congenital abnormality of the gastrointestinal (GI) tract that usually remains asymptomatic throughout a patient's lifetime. However, these diverticula can cause complications such as GI bleeding and small bowel obstruction; complications occur mostly in children and are rare in adults. This article reviews the presentation, complications, and treatment options for symptomatic and incidentally found Meckel diverticula.
Topics: Asymptomatic Diseases; Female; Humans; Incidental Findings; Meckel Diverticulum; Middle Aged
PubMed: 26302318
DOI: 10.1097/01.JAA.0000470434.61576.89 -
BMJ Case Reports Feb 2019
Topics: Aged; Hernia, Femoral; Humans; Male; Meckel Diverticulum
PubMed: 30824469
DOI: 10.1136/bcr-2018-228784 -
Current Gastroenterology Reports Jan 2020Meckel's diverticulum may be detected incidentally or present with symptoms from infancy and to old age. The presentation may be acute, with several complications... (Review)
Review
PURPOSE OF REVIEW
Meckel's diverticulum may be detected incidentally or present with symptoms from infancy and to old age. The presentation may be acute, with several complications associated with the condition. We aim to review the many faces with which a Meckel's diverticulum may present, either symptomatically or as an incidental finding.
RECENT FINDINGS
Due to its rarity, recent studies mainly include small retrospective series or case reports. Emphasis in the recent literature is on clinical presentation, the pathology of symptomatic cases, management options and risks of neoplasia. Symptoms are mainly caused by obstruction, bleeding or diverticulitis. Cross-sectional imaging is unspecific, although capsule endoscopy is reported of use in case series. Meckel's diverticulum presents with clinical features that are age-specific. Complicated Meckel's diverticulum is treated by resection. Optimal treatment of incidental cases remains debated. Meckel's diverticulum usually stays asymptomatic, and decision-making for management should be based on patient-specific factors. Use of minimal invasive techniques mandates refinement of the optimal treatment.
Topics: Humans; Incidental Findings; Meckel Diverticulum; Retrospective Studies
PubMed: 31930430
DOI: 10.1007/s11894-019-0742-1 -
Acta Medica Academica Dec 2022The objective of the current study was to describe the anatomical variations of vessels observed in patients with Meckel's Diverticulum. (Review)
Review
OBJECTIVE
The objective of the current study was to describe the anatomical variations of vessels observed in patients with Meckel's Diverticulum.
METHODS
A narrative review of the literature was undertaken by means of the PubMed database, using the terms: "Meckel's Diverticulum AND vessels", "Meckel's Diverticulum AND anatomical variation" and "Meckel's Diverticulum variation". Classical anatomical textbooks were also used for normal anatomy. Additional articles provided useful information in relation to the aim of this review. Hence, the articles that met the inclusion criteria were included in this review, and the collected data were categorized into a single table.
RESULTS
The majority of studies indicated the presence of an abnormal vitelline artery. Other angiographic findings concerned variations of the ileal and the iliac arteries. However, the literature revealed the presence of vascular variations without the existence of Meckel's Diverticulum, whereas a remnant of the vitelline vein may be present, but it is very rare.
CONCLUSION
The detection of vascular variations accompanying Meckel's Diverticulum is not always easy and requires the correct choice of imaging method to prevent misdiagnosis.
Topics: Humans; Meckel Diverticulum; Ileum; Angiography; Arteries; Veins
PubMed: 36799317
DOI: 10.5644/ama2006-124.394 -
AJR. American Journal of Roentgenology Mar 2022
Topics: Angiography; Arteries; Humans; Meckel Diverticulum; Vitelline Duct
PubMed: 34668386
DOI: 10.2214/AJR.21.26856 -
Pathologica Feb 2022Congenital anomalies of the tubular gastrointestinal tract are an important cause of morbidity not only in infants, but also in children and adults. The gastrointestinal... (Review)
Review
Congenital anomalies of the tubular gastrointestinal tract are an important cause of morbidity not only in infants, but also in children and adults. The gastrointestinal (GI) tract, composed of all three primitive germ layers, develops early during embryogenesis. Two major steps in its development are the formation of the gut tube (giving rise to the foregut, the midgut and the hindgut), and the formation of individual organs with specialized cell types. Formation of an intact and functioning GI tract is under strict control from various molecular pathways. Disruption of any of these crucial mechanisms involved in the cell-fate decision along the dorsoventral, anteroposterior, left-right and radial axes, can lead to numerous congenital anomalies, most of which occur and present in infancy. However, they may run undetected during childhood. Therapy is surgical, which in some cases must be performed urgently, and prognosis depends on early diagnosis and suitable treatment. A precise pathologic macroscopic or microscopic diagnosis is important, not only for the immediate treatment and management of affected individuals, but also for future counselling of the affected individual and their family. This is even more true in cases of multiple anomalies or syndromic patterns. We discuss some of the more frequent or clinically important congenital anomalies of the tubular GI, including atresia's, duplications, intestinal malrotation, Meckel's diverticulum and Hirschsprung's Disease.
Topics: Digestive System Abnormalities; Humans; Intestinal Volvulus; Meckel Diverticulum; Prognosis
PubMed: 35212315
DOI: 10.32074/1591-951X-553 -
European Journal of Radiology Dec 2022Inverted Meckel's diverticulum (IMD) is a well-established but rare disease. This study aimed to summarize the radiological and clinical characteristics of IMD, and...
PURPOSE
Inverted Meckel's diverticulum (IMD) is a well-established but rare disease. This study aimed to summarize the radiological and clinical characteristics of IMD, and correlates its radiological and surgical findings to obtain an accurate early preoperative diagnosis.
METHOD
This is a retrospective study included IMD patients from a large children's medical center in China, between January 2009 and March 2022. We reviewed demographic data, clinical manifestations, preoperative examinations, surgical findings, histopathological results, and outcomes.
RESULTS
Twenty-three cases with IMD (14 male patients [60.9%]; median age, 6.7 years; age range, 9 months to 13 years) were retrospectively reviewed over a period of 13 years. The typical clinical manifestations of IMD included abdominal pain, vomiting, and abdominal tenderness. The most commonly used imaging modalities were abdominal ultrasound and computed tomography. This is the first case series on pediatric IMD, that describes the clinical process of IMD, proposes clinical phases of IMD, and first summarizes the radiological findings characteristic of each clinical phase.
CONCLUSIONS
The clinical process of IMD can be divided into four phases (intussuscepted Meckel's diverticulum [MD], inverting MD, inverted MD, intussusception secondary to IMD). Patients in different clinical phases present with various radiological features. Mastering the radiological and clinical characteristics of each phase of IMD can aid in its early diagnosis and timely operative intervention, thus avoiding unnecessary intestinal necrosis and resection.
Topics: Child; Humans; Infant; Male; Abdominal Pain; Meckel Diverticulum; Radiography; Radiology; Research; Retrospective Studies
PubMed: 36402103
DOI: 10.1016/j.ejrad.2022.110611 -
Annals of Coloproctology Jul 2021Meckel diverticulum is a common congenital malformation of the gastrointestinal tract and can cause complications such as ulceration, hemorrhage, intussusception, and...
Meckel diverticulum is a common congenital malformation of the gastrointestinal tract and can cause complications such as ulceration, hemorrhage, intussusception, and perforation. This report describes a very rare complication of an enterovesical fistula associated with chronic Meckel diverticulum. A 51-year-old male presented with over 10 years of persistent pyuria. Tests were performed to rule out malignancy, including serum prostate-specific antigen level, urine cytology, bacterial culture, cystoscopy, and bladder computed tomography. An enterovesical fistula was identified, and laparoscopic exploration was performed. The findings suggested enterovesical fistula formation caused by chronic inflammation at the tip of a Meckel diverticulum. Segmental resection of the small bowel including the diverticulum and primary repair of the urinary bladder along with partial cystectomy were performed. The postoperative clinical course was uneventful. An enterovesical fistula is a very rare complication resulting from chronic inflammation of a Meckel diverticulum.
PubMed: 32178494
DOI: 10.3393/ac.2019.01.18