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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 -
Saudi Journal of Gastroenterology :... 2010Meckel's diverticulum is a true intestinal diverticulum that results from the failure of the vitelline duct to obliterate during the fifth week of fetal development. In... (Review)
Review
Meckel's diverticulum is a true intestinal diverticulum that results from the failure of the vitelline duct to obliterate during the fifth week of fetal development. In about 50% cases, it contains ectopic or heterotopic tissue which can be the cause of complications. A systematic review of literature was undertaken to study the history, incidence, embryoanatomy, clinical presentation, complication and management of Meckel's diverticulum. Although Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract, it is often difficult to diagnose. It may remain asymptomatic or it may mimic disorders such as Crohn's disease, appendicitis and peptic ulcer disease.
Topics: Diagnosis, Differential; Humans; Meckel Diverticulum
PubMed: 20065566
DOI: 10.4103/1319-3767.58760 -
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 -
The Journal of Trauma and Acute Care... Aug 2019Johann Friedrich Meckel (1781-1833) was a 19th century anatomist born into an eminent dynasty. He was a professor of anatomy, pathology, and zoology at the University of... (Review)
Review
Johann Friedrich Meckel (1781-1833) was a 19th century anatomist born into an eminent dynasty. He was a professor of anatomy, pathology, and zoology at the University of Halle, in Central Germany. The diverticulum, a congenital remnant of the vitellointestinal duct was named after him. Other eponyms include Meckel's cartilage, Meckel syndrome, and Meckel-Serres law of recapitulation. His concepts in comparative anatomy, embryology, and teratology anticipated Darwin. This review is a short tribute to this legend and his prolific contributions. LEVEL: Historic review, level V.
Topics: Germany; History, 19th Century; Humans; Meckel Diverticulum
PubMed: 31349351
DOI: 10.1097/TA.0000000000002300 -
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 -
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 -
The American Journal of Gastroenterology Jul 1990
Review
Topics: Diagnosis, Differential; Humans; Intestinal Neoplasms; Intestinal Obstruction; Meckel Diverticulum; Melena
PubMed: 2196781
DOI: No ID Found -
Journal of the American College of... May 2001
Review
Topics: Choristoma; Diverticulitis; Gastrointestinal Hemorrhage; Humans; Intestinal Obstruction; Intestinal Perforation; Intussusception; Meckel Diverticulum; Morbidity; Prevalence; Treatment Outcome
PubMed: 11333103
DOI: 10.1016/s1072-7515(01)00817-1 -
The American Journal of Emergency... Mar 1988Meckel's diverticulum is a cause of significant morbidity and mortality. Often this is related to the delay in diagnosis. Based on a US population of 200 million people... (Review)
Review
Meckel's diverticulum is a cause of significant morbidity and mortality. Often this is related to the delay in diagnosis. Based on a US population of 200 million people and a 2% incidence, there are 4 million Meckel's diverticula present waiting to cause symptoms. Considering that most Meckel's diverticula are asymptomatic and that many authors have described the condition as a great mimic, the diagnosis is often quite elusive. Therefore, a high index of suspicion is needed to diagnose Meckel's diverticulum correctly and expeditiously as the source of disease in the patient with an often unclear abdominal presentation. The difficulty with diagnosis should be lessened if one considers that Meckel's diverticulum presents largely in the male and younger age groups with the three major symptom complexes of bowel obstruction, gastrointestinal bleeding, and inflammation. Use of 99mTc pertechnetate scintigraphy appears to be the diagnostic study of choice if Meckel's diverticulum is suspected and the patient is clinically stable. When one considers the potential for bad outcome if Meckel's diverticulum is missed in the setting of possible obstruction or hemorrhage (i.e., bowel infarction or exsanguination), a high index of suspicion and diagnostic aggressiveness is warranted. Lastly, if one thought is to be left behind, it should be: "Meckel's is a great mimic that must be considered in all cases of intra-abdominal disease in which the cause is not readily apparent."
Topics: Adolescent; Gastrointestinal Hemorrhage; Humans; Male; Meckel Diverticulum
PubMed: 3281686
DOI: 10.1016/0735-6757(88)90055-1 -
American Family Physician Feb 2000Although Meckel's diverticulum is the most prevalent congenital abnormality of the gastrointestinal tract, it is often difficult to diagnose. It may remain completely... (Review)
Review
Although Meckel's diverticulum is the most prevalent congenital abnormality of the gastrointestinal tract, it is often difficult to diagnose. It may remain completely asymptomatic, or it may mimic such disorders as Crohn's disease, appendicitis and peptic ulcer disease. Ectopic tissue, found in approximately 50 percent of cases, consists of gastric tissue in 60 to 85 percent of cases and pancreatic tissue in 5 to 16 percent. The diagnosis of Meckel's diverticulum should be considered in patients with unexplained abdominal pain, nausea and vomiting, or intestinal bleeding. Major complications include bleeding, obstruction, intussusception, diverticulitis and perforation. The most useful method of diagnosis is with a technetium-99m pertechnetate scan, which is dependent on uptake of the isotope in heterotopic tissue. Management is by surgical resection.
Topics: Female; Humans; Meckel Diverticulum; Middle Aged; Patient Education as Topic; Teaching Materials
PubMed: 10706156
DOI: No ID Found