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Revista Espanola de Enfermedades... Nov 2018Meckel's diverticulum is the most common anomalous development of the gastrointestinal system that results from an incomplete vitelline canal. A diagnosis is usually... (Review)
Review
Meckel's diverticulum is the most common anomalous development of the gastrointestinal system that results from an incomplete vitelline canal. A diagnosis is usually made during the clinical examination of presentations such as unexplained gastrointestinal bleeding, obstruction, inflammation or perforation. The purpose of this review is to provide an adequate level of knowledge of the clinical and diagnostic features as well as the management of Meckel's diverticulum. Diagnosis of Meckel's diverticulum may be challenging as the condition remains asymptomatic or may mimic various diseases and obscure the clinical picture. Life-threatening complications include bleeding, obstruction, inflammation and perforation. Therefore, it is essential that anatomical and pathophysiological characteristics are known in detail in order to prevent complications which will result in morbidity and mortality.
Topics: Humans; Meckel Diverticulum
PubMed: 30032625
DOI: 10.17235/reed.2018.5628/2018 -
Medicine Aug 2018The contemporary demographics and prevalence of Meckel's diverticulum, clinical presentation and management is not well described. Thus, this article aims to review the... (Review)
Review
BACKGROUND
The contemporary demographics and prevalence of Meckel's diverticulum, clinical presentation and management is not well described. Thus, this article aims to review the recent literature concerning Meckel's diverticulum.
METHODS
A systematic PubMed/Medline database search using the terms "Meckel" and "Meckel's" combined with "diverticulum." English language articles published from January 1, 2000 to July 31, 2017 were considered. Studies reporting on the epidemiology of Meckel's diverticulum were included.
RESULTS
Of 857 articles meeting the initial search criteria, 92 articles were selected. Only 4 studies were prospective. The prevalence is reported between 0.3% and 2.9% in the general population. Meckels' diverticulum is located 7 to 200 cm proximal to the ileocecal valve (mean 52.4 cm), it is 0.4 to 11.0 cm long (mean 3.05 cm), 0.3 to 7.0 cm in diameter (mean 1.58 cm), and presents with symptoms in 4% to 9% of patients. The male-to-female (M:F 1.5-4:1) gender distribution is reported up to 4 times more frequent in men. Symptomatic patients are usually young. Of the pediatric symptomatic patients, 46.7% have obstruction, 25.3% have hemorrhage, and 19.5% have inflammation as presenting symptom. Corresponding values for adults are 35.6%, 27.3%, and 29.4%. Ectopic gastric tissue is present in 24.2% to 71.0% of symptomatic Meckel's diverticulum, is associated with hemorrhage and is the most common form of ectopic tissue, followed by ectopic pancreatic tissue present in 0% to 12.0%.
CONCLUSION
The epidemiological patterns and clinical presentation appears stable in the 21st century. A symptomatic Meckel's diverticulum is managed by resection. The issue of prophylactic in incidental Meckel's diverticulum resection remains controversial.
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Choristoma; Disease Management; Female; Humans; Ileocecal Valve; Male; Meckel Diverticulum; Middle Aged; Pancreas; Prevalence; Sex Distribution; Stomach; Young Adult
PubMed: 30170459
DOI: 10.1097/MD.0000000000012154 -
Journal of Gastrointestinal and Liver... Dec 2019In this session different problems regarding the pathogenesis of diverticular disease were considered, including "Genetics", "Neuromuscular function abnormalities",...
In this session different problems regarding the pathogenesis of diverticular disease were considered, including "Genetics", "Neuromuscular function abnormalities", "Patterns of mucosa inflammation", and "Impact of lifestyle". The patients affected by diverticular disease have clear genetic pattern, that might predispose to the occurrence of the disease as well as to its complications. Neuromuscular abnormalities may be recognized already at the stage of diverticulosis, and inflammation may explain symptoms occurrence in symptomatic uncomplicated diverticular disease (SUDD) or symptoms persistence after an episode of acute diverticulitis. Finally, lifestyle might also have an impact on symptoms' occurrence. Specifically smoking, but also obesity seem to play an important role, while the role of low-fiber diet and constipation is now under debate.
Topics: Colon; Diverticular Diseases; Diverticulum; Gastrointestinal Motility; Genetic Predisposition to Disease; Humans; Life Style; Obesity; Sensation; Sensation Disorders; Smoking
PubMed: 31930230
DOI: 10.15403/jgld-551 -
Ugeskrift For Laeger Oct 2022Ehlers-Danlos syndrome (EDS) is a group of hereditary connective tissue disorders which are clinically characterized by hypermobility of joints, hyperelasticity of skin...
Ehlers-Danlos syndrome (EDS) is a group of hereditary connective tissue disorders which are clinically characterized by hypermobility of joints, hyperelasticity of skin and tissue insufficiency, sometimes leading to herniation, bleeding, and organ rupture. This is a case report of a 55-year-old man with EDS and a big bladder diverticulum in which we discuss treatment strategy in patients with EDS and bladder diverticula. Initially, treatment approach should be conservative due to high recurrence rates and potential complications following surgical procedures. Invasive procedures - preferably minimally invasive - may be indicated, based on an individual risk evaluation.
Topics: Male; Humans; Middle Aged; Ehlers-Danlos Syndrome; Urinary Bladder; Diverticulum; Skin
PubMed: 36331320
DOI: No ID Found -
Annals of the Royal College of Surgeons... Nov 2022We report a rare complication involving a healthy 45-year-old male patient who underwent an emergency laparoscopic appendicectomy for acute perforated gangrenous...
We report a rare complication involving a healthy 45-year-old male patient who underwent an emergency laparoscopic appendicectomy for acute perforated gangrenous appendicitis. The patient was catheterised pre- procedure and the ports were inserted under vision. Upon completion of the procedure, a 15 Fr Robinson drain was left in the pelvis and was fed through the suprapubic port hole. Postoperatively the patient developed worsening, generalised abdominal pain and high output from the drain. The patient was re-catheterised but the computed tomography (CT) cystogram did not show any injury to the bladder. The drain fluid creatinine was noted to be raised (>4,000), indicating that urine was leaking into the drain. Conventional cystogram confirmed a contrast leak from the dome around the drain. Flexible cystoscopy confirmed that the drain had transversed the vesicourachal diverticula. The drain was pulled back and converted to a suprapubic catheter with the patient subsequently being discharged. Vesicourachal diverticula is a rare and often asymptomatic anomaly. When undertaking laparoscopic surgery, precautions should be taken to prevent port site injury such as catheterising the patient to ensure the bladder is empty and inserting the ports under direct vision. It is safer to visualise muscle rather than peritoneum during port insertion. In this case, the bladder diverticula was noticed extraperitoneally. Though the indirect CT cystogram reported no injury, this was unreliable as the bladder was not distended which led to the subtle injury being missed. Traditional cystogram should be considered in cases with a negative CT cystogram and a strong suspicion of bladder injury.
Topics: Male; Humans; Middle Aged; Urinary Bladder; Diverticulum; Urinary Bladder Diseases; Cystoscopy
PubMed: 35446699
DOI: 10.1308/rcsann.2021.0344 -
Ugeskrift For Laeger Apr 2024Meckel's diverticulum is the most common congenital gastrointestinal defect with a prevalence of 2%. It is mostly asymptomatic and it rarely causes acute abdomen in...
Meckel's diverticulum is the most common congenital gastrointestinal defect with a prevalence of 2%. It is mostly asymptomatic and it rarely causes acute abdomen in adults. In this case report, a 28-year-old male with no previous abdominal surgery presented with clinical symptoms of small bowel obstruction. Surgery revealed a Meckel's diverticulum adherent to the abdominal wall, causing internal herniation with small bowel obstruction. The diverticulum was openly resected and no post-operative complications occurred. Laparoscopy seems safe, and surgical removal of the symptomatic Meckel's diverticulum is recommended.
Topics: Humans; Meckel Diverticulum; Adult; Male; Ileus; Tomography, X-Ray Computed; Intestinal Obstruction
PubMed: 38704710
DOI: 10.61409/V10230632 -
World Journal of Gastroenterology Jan 2024Esophageal intramural pseudodiverticulosis (EIPD) is a disease of unknown pathogenesis characterized by usually systemic, cystic dilatation of the excretory ducts of... (Review)
Review
Esophageal intramural pseudodiverticulosis (EIPD) is a disease of unknown pathogenesis characterized by usually systemic, cystic dilatation of the excretory ducts of esophageal submucosal glands. In this article, I review the epidemiology, clinical manifestations, endoscopic findings, esophagographic findings, and histopathology of EIPD. I also discuss the etiology and possible pathogenesis of EIPD based on my experiences with this disease and a review of the literature. EIPD usually presents with dysphagia in middle-aged individuals. It is often complicated with secondary infections, most commonly candidiasis. On esophagography, EIPD is delineated as small, multiple, flask-shaped outward projections within the esophageal wall. In recent years, EIPD has been mainly diagnosed by endoscopic findings of multiple, localized, small mucosal depressions. The orifices of the "pseudodiverticula" periodically open and close, and excrete mucus onto the mucosal surface. On histopathological examination, the luminal surface of dilated ducts in EIPD is covered by multilayered, hyperplastic epithelial cells, but myoepithelial cells in the glandular acini are well preserved. Treatment of EIPD is usually symptomatic therapy, and prevention of the infectious complications is important. The etiology and pathogenesis of EIPD are largely unknown, but functional abnormalities of autonomic nerve fibers innervating the esophageal glands likely play an important role, since the structures of the glands are basically preserved in this disease.
Topics: Middle Aged; Humans; Diverticulum, Esophageal; Deglutition Disorders; Diverticulum; Mucous Membrane; Esophageal Stenosis
PubMed: 38312118
DOI: 10.3748/wjg.v30.i2.137 -
Medicina 2020
Topics: Diverticulum; Humans
PubMed: 32841144
DOI: No ID Found -
BMJ Case Reports Jul 2014We present the case of a 77-year-old woman who initially presented 13 years ago to a colorectal clinic with a change in bowel habit and bleeding per rectum over 7...
We present the case of a 77-year-old woman who initially presented 13 years ago to a colorectal clinic with a change in bowel habit and bleeding per rectum over 7 months. These symptoms were attributed to a tubulovillous rectal adenoma which was excised transanally, but recurred five times in 12 years. The most recent endoscopy showed recurrence of the rectal adenoma and a new rectal diverticulum. Diverticula in the rectum are rare and only a few reports of this condition exist in the literature. Repeated surgical resections and endoscopic polypectomies may have caused a weakness in the rectal wall and led to a pseudodiverticulum.
Topics: Adenoma, Villous; Aged; Diverticulum; Diverticulum, Colon; Endoscopy; Female; Humans; Intestinal Polyps; Neoplasm Recurrence, Local; Rectal Diseases; Rectal Neoplasms
PubMed: 25006050
DOI: 10.1136/bcr-2013-201888 -
BMJ Case Reports Feb 2019
Topics: Aged; Hernia, Femoral; Humans; Male; Meckel Diverticulum
PubMed: 30824469
DOI: 10.1136/bcr-2018-228784