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In Vivo (Athens, Greece) 2023Meckel's diverticulum carcinoma (MDCa) is extremely rare. It is often advanced when found, and the prognosis is poor. Effective treatment for this cancer has not yet...
Meckel's Diverticulum Carcinoma Is Arrested by Oxaliplatinum and Eradicated by 5-Fluorouracil in a PDX Mouse Model Indicating Candidate First-line Treatment for a Rare Cancer.
BACKGROUND/AIM
Meckel's diverticulum carcinoma (MDCa) is extremely rare. It is often advanced when found, and the prognosis is poor. Effective treatment for this cancer has not yet been developed. We previously established a patient-derived xenograft (PDX) nude-mouse model of MDCa. In the present study, we investigated the efficacy of oxaliplatinum (L-OHP) and 5-fluorouracil (5-FU) on an MDCa PDX nude-mouse model.
MATERIALS AND METHODS
PDX mouse models of MDCa were divided into three groups (five mice per group): untreated control; L-OHP-treated; and 5-FU-treated. Tumor volumes of the three groups were compared after 2 weeks.
RESULTS
L-OHP arrested tumor growth (p=0.038) and 5-FU apparently eradicated the tumor (p=0.007).
CONCLUSION
L-OHP and 5-FU are candidates for clinical first-line therapy of MDCa.
Topics: Humans; Mice; Animals; Fluorouracil; Meckel Diverticulum; Oxaliplatin; Treatment Outcome; Carcinoma
PubMed: 37369464
DOI: 10.21873/invivo.13232 -
International Journal of Surgery Case... Jun 2024Enteric duplication cysts (EDC) are rare anomalies of the gastrointestinal tract, with only 0.4 % occurring in the cecum. Meckel's diverticulum (MD) is a common...
INTRODUCTION
Enteric duplication cysts (EDC) are rare anomalies of the gastrointestinal tract, with only 0.4 % occurring in the cecum. Meckel's diverticulum (MD) is a common congenital anomaly affecting up to 2 % of the population. The simultaneous occurrence of these two conditions is rare with no existing guideline on treatment.
CASE PRESENTATION
An 11-month-old boy presented with fever, vomiting, and abdominal distension. A contrast-enhanced computed tomography scan confirmed the diagnosis of an enteric duplication cyst causing intestinal obstruction. The patient underwent exploratory laparotomy, during which a cecal duplication cyst measuring 30 × 20 mm was found along with MD in the distal ileum. Right limited hemicolectomy was performed. Histopathological examination revealed features consistent with an enteric duplication cyst and the presence of gastric mucosal heterotopia.
CLINICAL DISCUSSION
Differentiating EDC from MD is a significant challenge, as both can present with similar symptoms and be positive on a Tc-99 m radionuclide scan. The final diagnosis of EDC and MD can only be made by correlating the imaging findings with the surgical findings and pathological features.
CONCLUSION
Cecal duplication cysts should be considered a differential diagnosis in infants who present with intestinal obstruction. Although their presentation may resemble that of Meckel's diverticulum, both conditions can coexist. Excision of duplication cysts in children is considered a safe and efficient treatment approach.
PubMed: 38943938
DOI: 10.1016/j.ijscr.2024.109943 -
Frontiers in Surgery 2021Meckel diverticulum (MD) is the most common congenital anomaly of the intestines, with an incidence of 2% of the general population. It can present as various clinical...
Meckel diverticulum (MD) is the most common congenital anomaly of the intestines, with an incidence of 2% of the general population. It can present as various clinical features with complications and be life threatening if diagnosis is delayed and treatment late. We report three pediatric cases with complicated MD: one female presented with small-bowel obstruction, one male with peritonitis, and one female with severe iron-deficiency anemia, without gross gastrointestinal bleeding nor any ectopic gastric mucosa. All patients underwent exploratory laparotomy, segmental small-bowel resection, and primary anastomosis. They successfully recovered and were uneventfully discharged on the fourth, seventh, and 10th postoperative days, respectively. MD can present with various complication spectrums, including small-bowel obstruction, peritonitis, and severe iron-deficiency anemia, which may cause difficulty in definitive diagnosis, particularly in children. Segmental small-bowel resection and primary anastomosis are effective surgical approaches and show good outcomes for MD patients.
PubMed: 34113646
DOI: 10.3389/fsurg.2021.674382 -
International Journal of Surgery Case... Feb 2021Meckel's diverticulum is a common congenital anomaly found in ∼2% of the population, its classic location aiding in its diagnostic criteria, is the anti-mesenteric...
Meckel's diverticulum is a common congenital anomaly found in ∼2% of the population, its classic location aiding in its diagnostic criteria, is the anti-mesenteric side of the distal ileum. However, reported cases of Meckel's diverticula found on the mesenteric side, are present but rare. Here we report a case of a perforated mesenteric Meckel's diverticulum with synchronised anti-mesenteric Meckel's diverticulum, in a 70-year-old male, initially misdiagnosed as left strangulated inguinal hernia. The purpose behind this paper is to raise clinical suspicion regarding this rare pathology, so that timely diagnosis and management could be carried out.
PubMed: 33486309
DOI: 10.1016/j.ijscr.2021.01.027 -
Surgical Case Reports Feb 2024Malignant neoplasms arising from Meckel's diverticulum are rare and an adenocarcinoma in Meckel's diverticulum originating from ectopic pancreatic tissue is even rarer....
BACKGROUND
Malignant neoplasms arising from Meckel's diverticulum are rare and an adenocarcinoma in Meckel's diverticulum originating from ectopic pancreatic tissue is even rarer. Herein, we report a patient with an ectopic pancreatic adenocarcinoma in Meckel's diverticulum who was successfully treated with surgery and chemotherapy.
CASE PRESENTATION
A woman in her sixties presented to another hospital with abdominal pain. Plain computed tomography suggested an abdominal tumor and she was referred to our hospital. Enhanced computed tomography revealed a 23-mm low-density tumor in the abdominal cavity. Surgery was performed with a tentative diagnosis of a mesenteric tumor, such as a gastrointestinal stromal tumor, schwannoma, or lymphoma. First, we inspected the peritoneal cavity with a laparoscope. This revealed numerous nodules in the small bowel mesentery, suggesting peritoneal dissemination. A 20-mm-diameter white tumor was found in the small intestine and diagnosed as a small intestinal cancer. The small intestine was partially resected laparoscopically through a small skin incision. The patient's postoperative course was uneventful, and she was discharged on postoperative day 9. Pathological examination revealed well-differentiated adenocarcinoma in the small intestine. The tumor had developed from a sac-like portion protruding toward the serosal side and had a glandular structure lined with flattened atypical cells. Neither pancreatic acinar cells nor islets of Langerhans were evident, suggesting a Heinrich type 3 ectopic pancreas. The final diagnosis was an adenocarcinoma originating from an ectopic pancreas in Meckel's diverticulum. After a smooth recovery, the patient commenced chemotherapy for pancreatic cancer.
CONCLUSIONS
We present a very rare case of ectopic pancreatic carcinoma in Meckel's diverticulum.
PubMed: 38388714
DOI: 10.1186/s40792-024-01843-8 -
Journal of Surgical Case Reports May 2022Meckel's diverticulum is a congenital anomaly leading to the formation of a true diverticulum in the distal small intestine. Though most are asymptomatic and discovered...
Meckel's diverticulum is a congenital anomaly leading to the formation of a true diverticulum in the distal small intestine. Though most are asymptomatic and discovered incidentally, Meckel's diverticuli can give rise to a wide range of symptoms. Rarely, this can be a malignancy, most commonly a carcinoid tumor. Other cancers have also been reported, with adenocarcinomas being particularly rare. Here, we report the case of a 62-year-old man presenting to the emergency room with vague gastrointestinal symptoms. Subsequent workup revealed a 3 cm mass in the distal jejunum/proximal ileum, which was located within a previously undiagnosed Meckel's diverticulum. The mass was sent to pathology, who confirmed an adenocarcinoma arising from a small bowel diverticulum. This case serves as an important reminder of the malignant potential of a Meckel's diverticulum and adds to the ongoing discussion regarding whether prophylactic diverticulectomy should be recommended to patients with a known Meckel's diverticulum.
PubMed: 35611002
DOI: 10.1093/jscr/rjac128 -
Cureus Apr 2023Although Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, it is rare in the general adult population. When it does become...
Although Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, it is rare in the general adult population. When it does become symptomatic, it is usually due to complications such as perforation. We report the case of a 38-year-old man who presented with acute abdominal pain in the right iliac fossa, fever, and tachycardia. Complementary exams at the emergency department showed leukocytosis and elevated C-reactive protein. Acute appendicitis was suspected, so he was taken to the operating room for a diagnostic laparoscopy. During surgical exploration, a perforated Meckel's diverticulum caused by a toothpick was found. Surgery was converted to laparotomy with resection of the small bowel segment containing the diverticulum, followed by a primary anastomosis. The postoperative period was uneventful, and the patient was discharged on day seven. No abnormalities were reported in the histopathology study. In this report, we review and discuss similar cases found in the literature, all of them male with acute abdomen and suspicion of appendicitis. We aim to remark on the importance of keeping in the differential of such patients a perforated Meckel's diverticulum.
PubMed: 37182090
DOI: 10.7759/cureus.37390 -
Bulletin of Emergency and Trauma Apr 2021Meckel's diverticulum is the most common gastrointestinal congenital defect, which, although asymptomatic in adults, may present symptoms in obstruction, inflammation,...
Meckel's diverticulum is the most common gastrointestinal congenital defect, which, although asymptomatic in adults, may present symptoms in obstruction, inflammation, bleeding and foreign body perforation. There are only 8 reported cases of Meckel's diverticulum perforation by chicken bone. We report a case of a 24-year-old man presenting a 2-day-history of periumbilical pain that shifted to the right lower quadrant in 24 hours. Clinical and laboratory findings led to an appendicitis diagnosis, followed by laparotomy. Normal appendix was found intraoperatively along with an incidental finding of an inflamed and perforated Meckel's diverticulum by chicken bone. Diverticulectomy and enteroanastomosis were performed and the patient had a successful recovery, being discharged after 5 days. Although rare, its clinical presentation might be similar to acute appendicitis, which restate the importance of collecting a detailed clinical history and examining the small bowel in order to investigate a possible Meckel's diverticulum complication in the differential diagnosis.
PubMed: 34150921
DOI: 10.30476/BEAT.2021.86253 -
International Journal of Surgery Case... Aug 2021The concurrent existence of Omphalocele and Meckel's diverticulum is not unheard of but is relatively uncommon. A few cases of their coexistence have been reported. Due...
INTRODUCTION AND IMPORTANCE
The concurrent existence of Omphalocele and Meckel's diverticulum is not unheard of but is relatively uncommon. A few cases of their coexistence have been reported. Due to the uncommon dual presentation, it is easy to delay or even miss the diagnosis, delaying management. Meckel's diverticulum should be considered if there is a bowel opening on an omphalocele.
CASE PRESENTATION
Herein we present a newborn male baby who was referred to us presenting with an omphalocele that was leaking faeces. The baby also had a cleft lip and palate. He was born at term to a 30-year-old mother whose pregnancy was otherwise normal. The fistulated omphalocele was surgically repaired, and the child continued to do well.
CLINICAL DISCUSSION
Omphalocele and Meckel's diverticulum are both relatively rare congenital malformations that are uncommonly present together. Other congenital malformations can be associated; hence thorough investigations should be carried out when resources are available. The search for associated malformation should not delay the management of the pathology as it can have serious consequences on the health and outcome of the child.
CONCLUSION
Fistulation of Meckel's diverticulum on an Omphalocele is rare. Treatment involves surgical resection and repair. Though other co-morbidities should be investigated, investigation for cause and other co-morbidities should not delay surgery.
PubMed: 34332471
DOI: 10.1016/j.ijscr.2021.106246 -
The Journal of Infectious Diseases Nov 2021Ileal perforation occurs in about 1% of enteric fevers as a complication, with a case fatality risk (CFR) of 20%-30% in the early 1990s that decreased to 15.4% in 2011...
BACKGROUND
Ileal perforation occurs in about 1% of enteric fevers as a complication, with a case fatality risk (CFR) of 20%-30% in the early 1990s that decreased to 15.4% in 2011 in South East Asia. We report nontraumatic ileal perforations and its associated CFR from a 2-year prospective enteric fever surveillance across India.
METHODS
The Surveillance for Enteric Fever in India (SEFI) project established a multitiered surveillance system for enteric fever between December 2017 and March 2020. Nontraumatic ileal perforations were surveilled at 8 tertiary care and 6 secondary care hospitals and classified according to etiology.
RESULTS
Of the 158 nontraumatic ileal perforation cases identified,126 were consented and enrolled. Enteric fever (34.7%), tuberculosis (19.0%), malignancy (5.8%), and perforation of Meckel diverticulum (4.9%) were the common etiology. In those with enteric fever ileal perforation, the CFR was 7.1%.
CONCLUSIONS
Enteric fever remains the most common cause of nontraumatic ileal perforation in India, followed by tuberculosis. Better modalities of establishing etiology are required to classify the illness, and frame management guidelines and preventive measures. CFR data are critical for comprehensive disease burden estimation and policymaking.
Topics: Cost of Illness; Humans; India; Intestinal Perforation; Prospective Studies; Typhoid Fever
PubMed: 35238354
DOI: 10.1093/infdis/jiab258