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The British Journal of Surgery Dec 2020
Topics: Aged; Humans; Intestinal Obstruction; Intestine, Small; Male; Meckel Diverticulum; Tomography, X-Ray Computed
PubMed: 33179806
DOI: 10.1002/bjs.12036 -
ANZ Journal of Surgery May 2023Meckels diverticulum (MD) causes a number of acute surgical pathologies and can contain ectopic tissue with the surgical aim to resect all ectopic mucosa. This has...
BACKGROUND
Meckels diverticulum (MD) causes a number of acute surgical pathologies and can contain ectopic tissue with the surgical aim to resect all ectopic mucosa. This has traditionally implied a small bowel resection (BR); though contemporary literature has demonstrated Meckel's diverticulectomy to be safe. The aim of this study was to determine optimal resection strategy, and assess MD histopathological features and their relationship to outcomes.
METHODS
A 19-year retrospective review of patient medical records across seven hospitals was conducted with demographic, clinical and pathological data collected. Analysis was conducted using a student's t-test for continuous variables and chi-squared test for categorical variables. Univariate regression was performed to identify risk factors. P < 0.05 was considered statistically significant.
RESULTS
One hundred and sixty patients underwent resection of MD, 70 (44%) had Meckel's diverticulectomy and 90 (56%) had BR. No significant difference in length (P = 0.486), width (P = 0.238), or ratio (P = 0.188) of diverticulectomy compared to BR, with fewer complications in diverticulectomy. In all, 24 (15.3%) MD were perforated, of whom 5 had gastric mucosa, 2 had mixed ectopic mucosa and 1 carcinoid tissue. There were no cases of ectopic mucosa in the resection margin requiring re-operation, or causing base perforation. MD specimen with greater length: width ratio was a risk factor for perforation OR 1.437 P = 0.042 but not for malignancy P = 0.813 or ectopic tissue P = 0.185.
CONCLUSION
Meckel's diverticulectomy is safe via laparoscopic or open approach compared with BR. Despite higher perforation rates in MD with greater length: width ratio, no malignancy or ectopic risk was identified, supporting diverticulectomy as a safe operative approach.
Topics: Humans; Retrospective Studies; Choristoma; Digestive System Surgical Procedures; Meckel Diverticulum; Laparoscopy
PubMed: 36821518
DOI: 10.1111/ans.18351 -
Journal of Gastrointestinal Surgery :... Oct 2021
Topics: Echinococcosis; Humans; Meckel Diverticulum
PubMed: 33835363
DOI: 10.1007/s11605-021-04998-z -
Balkan Medical Journal Apr 2020
Topics: Child, Preschool; Female; Humans; Intestinal Obstruction; Meckel Diverticulum
PubMed: 31937023
DOI: 10.4274/balkanmedj.galenos.2020.2019.11.23 -
Histopathology Dec 2015Histological features of chronic active ileitis in the small intestine neighbouring a Meckel's diverticulum raise the possibility of concurrent Crohn's disease. Several...
AIMS
Histological features of chronic active ileitis in the small intestine neighbouring a Meckel's diverticulum raise the possibility of concurrent Crohn's disease. Several studies have reported a significant association between Meckel's diverticulum and Crohn's disease, whereas some case reports have proposed that the ileitis is attributable to acid-secreting gastric heterotopia. The aim of this study was to evaluate the incidence, histomorphology and clinical follow-up of Meckel's diverticulum-associated ileitis.
METHODS AND RESULTS
Medical records and slides from 48 consecutive surgical resections performed for Meckel's diverticulum were reviewed. Nine of 48 adults had significant inflammatory changes in the small intestine neighbouring the diverticulum. Two were transmural ulcers attributable to ingestion of a sharp object. Two patients had established Crohn's disease, both with long segments (>95 mm) of transmural inflammation located >100 mm from the diverticulum. The remaining five patients had inflammatory changes (ulceration, pseudopyloric metaplasia, submucosal fibrosis, and muscularis mucosa hyperplasia) confined to a short segment (<20 mm) of mucosa/submucosa within 50-60 mm of the diverticulum. Two had gastric heterotopia in the diverticulum. None of these five patients used non-steroidal anti-inflammatory drugs (NSAIDs). On follow-up, none had symptoms, imaging or pathology suggestive of Crohn's disease.
CONCLUSIONS
Ileitis affecting a short segment of mucosa and submucosa in the small intestine near a Meckel's diverticulum is relatively common, and is not necessarily related to Crohn's disease.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Crohn Disease; Female; Humans; Ileitis; Intestinal Mucosa; Intestine, Small; Male; Meckel Diverticulum; Middle Aged; Young Adult
PubMed: 25892011
DOI: 10.1111/his.12717 -
Indian Journal of Pediatrics Sep 2019The bowel is a challenging abdominal organ to image. A variety of bowel disorders such as congenital, developmental, inflammatory, infectious and neoplastic lesions can... (Review)
Review
The bowel is a challenging abdominal organ to image. A variety of bowel disorders such as congenital, developmental, inflammatory, infectious and neoplastic lesions can affect children and most of them are either unique to this age group or have a distinct clinico-radiological appearance compared to adults. Imaging forms an integral part of management of these disorders. This article will cover inflammatory/infective, neoplastic and miscellaneous disorders affecting the bowel. The authors will highlight the salient imaging features for those entities.
Topics: Abdominal Cavity; Adenocarcinoma; Appendicitis; Carcinoid Tumor; Celiac Disease; Child; Crohn Disease; Diagnostic Imaging; Enteritis; Enterocolitis, Necrotizing; Enterocolitis, Neutropenic; Eosinophilia; Gastritis; Gastrointestinal Diseases; Gastrointestinal Stromal Tumors; Humans; Intussusception; Lymphoma; Meckel Diverticulum; Neoplasms; Teratoma; Tuberculosis
PubMed: 30790185
DOI: 10.1007/s12098-019-02878-8 -
The Surgical Clinics of North America Oct 2022The small intestine is a complex organ system that is vital to the life of the individual. There are several congenital anomalies that occur and present most commonly in... (Review)
Review
The small intestine is a complex organ system that is vital to the life of the individual. There are several congenital anomalies that occur and present most commonly in infancy; however, some may not present until adulthood. Most congenital anomalies of the small intestine will present with obstructive symptoms, whereas some may present with vomiting, abdominal pain, and/or gastrointestinal bleeding. Various radiologic procedures can aid in the diagnosis of these lesions that vary depending on the particular anomaly. The congenital anomalies of the small intestine discussed include Meckel diverticulum, duodenal web, duodenal atresia, jejunoileal atresia, and intestinal duplications.
Topics: Abdomen; Adult; Digestive System Abnormalities; Duodenal Obstruction; Humans; Intestinal Atresia; Meckel Diverticulum
PubMed: 36209748
DOI: 10.1016/j.suc.2022.07.012 -
The American Journal of Gastroenterology Jun 2023
Topics: Humans; Meckel Diverticulum; Laparoscopy; Endoscopy, Gastrointestinal; Diverticulum
PubMed: 36689733
DOI: 10.14309/ajg.0000000000002141 -
In Vivo (Athens, Greece) 2022Cancer of the Meckel's diverticulum (MD) is extremely rare. It is often advanced at the time of operation and the prognosis is poor. An effective treatment for this...
BACKGROUND
Cancer of the Meckel's diverticulum (MD) is extremely rare. It is often advanced at the time of operation and the prognosis is poor. An effective treatment for this cancer has not yet been developed and there is no MD-carcinoma mouse model.
MATERIALS AND METHODS
MD carcinoma was established as a patient-derived xenograft (PDX) in 5-week-old male nude mice by subcutaneous transplantation of surgical specimens together with surrounding normal tissue. Hematoxylin and eosin (H&E) staining was performed on paraffin-embedded tissue sections of the original tumor resected from patients and transplanted tumors grown in nude mice.
RESULTS
Three of five mice implanted with MD tumor fragments grew. MD-carcinoma histopathology, observed with H&E-stained tissue sections of the tumors grown in the mice and tumor from the original patient, was concordant. Both showed the luminal structures characteristic of MD carcinoma, and the lumens were filled with serous fluid.
CONCLUSION
The first PDX mouse model of MD carcinoma has been established. The PDX model maintained MD-carcinoma histology of the tumor in the patient. The MD carcinoma mouse model will enable basic research on MD carcinoma, as well as the testing of novel therapeutic agents.
Topics: Animals; Carcinoma; Disease Models, Animal; Humans; Male; Meckel Diverticulum; Mice; Mice, Nude; Prognosis; Treatment Outcome
PubMed: 35738609
DOI: 10.21873/invivo.12870 -
Chirurgia (Bucharest, Romania : 1990) 2018Meckel's diverticulum is a congenital anomaly which can become complicated or remain asymptomatic throughout life. During pregnancy, however, diverticulum infection...
Meckel's diverticulum is a congenital anomaly which can become complicated or remain asymptomatic throughout life. During pregnancy, however, diverticulum infection could become a serious complication. Diverticulum necrosis and perforation are complications that increase morbidity in pregnancy, both maternal and fetal. The rarity of the condition and the maternal physiological changes in pregnancy make the diagnosis difficult. We present the case of a Meckel's diverticulum gangrene in third trimester pregnancy, atypical case due to advanced pregnancy where the risk-benefit balance was carefully evaluated on one hand because of the risk of infection associated with expectant management and on the other hand the risk and complications of iatrogenic preterm premature birth. The outcome was favorable for both mother and newborn.
Topics: Adult; Cesarean Section; Female; Humans; Infarction; Meckel Diverticulum; Pregnancy; Pregnancy Complications; Pregnancy Trimester, Third; Torsion Abnormality; Treatment Outcome
PubMed: 29733021
DOI: 10.21614/chirurgia.113.2.266